Hi Pauline, sorry to hear about your knee. Yes, capsaicin/capsicum cause stimulation of nerves endings so their chemicals are depleted and they reduce the level of pain messages they send on. The brain also naturally dismisses persistent signals. Some people do find it irritating, however, but better than the traditional treatments that mimic this action -bee stings and nettles! Best wishes, Sarah B
A 2015 Cochrane review of 61 studies involving nearly 8,400 people found that topical NSAIDs relieved pain from strains, sprains, and overuse injuries, but with less side effects than oral NSAIDs. Similarly, a 2006 review of four randomized trials found that topical diclofenac reduced knee pain due to osteoarthritis and was generally well tolerated. 
I’m not saying NSAIDs are useless. They have their place. If you’re recovering from surgery or a major injury, traditional over-the-counter pain relievers are good for controlling inflammation, swelling, and pain, but NSAIDs are far too powerful for over-the-counter, everyday use. Unlike a lot of natural pain relievers, NSAIDs also don’t address the cause of inflammation or pain; they just mask the symptoms.
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