When we think of a chili pepper, we imagine it in adding its distinctive spiciness to food. But how about in a pain relief cream? Strange as it may sound, chili peppers have traditionally been used as a topical painkiller, usually made by crushing the fruit and mixing it with a neutral base or applying the pulp directly to the skin. A modern version of this is the capsaicin pain relief cream available in tubes or jars or as the active ingredient in heating pads for sale at most drugstores. Among the conditions it is used for are back pain, bursitis, fibromyalgia, joint pain, muscle pain, nerve pain, osteoarthritis, pain due to diabetes, neuropathy, phantom pain after amputation, post-herpetic neuralgia, post-surgical neuropathic pain, and rheumatoid arthritis. It can also relieve itching (pruritis).