In traditional medicine, cayenne is used for gout, arthritis, sciatica, muscle pain and coughs. In compound preparations, it is used for loss of appetite, dyspepsia, and diarrhea. Preliminary studies suggest the cardiovascular benefits of cayenne. The chief component, capsaicin, has been found to be useful topically in reducing arthritic pain, muscular tension and also neuropathic pain in patients with diabetes. Internally, capsaicin has shown gastroprotective effect and reduction of nausea and vomiting.

Cayenne pepper has been used by Native Americans as both food and medicine for at least 9,000 years. Chili pepper was found to be used for gourd and squash preservation in archeological research in central Peru at a preceramic site dating to approximately 2200 BC.

Capsaicin, the active ingredient in cayenne peppers, gives the powder its spiciness and is used to treat aches and pains of the muscles and joints. Cayenne pepper has also been used in traditional Chinese and Ayurvedic medicines to help treat circulatory problems and increase appetite.