Topical NSAIDs provide relief from arthritis pain
For those suffering from osteoarthritis of the knees or hands, applying topical non-steroidal anti-inflammatory drugs (NSAIDs)—in the form of creams, gels and patches—can bring weeks of pain relief, finds a new review by The Cochrane Library.
While oral NSAIDs are more common for managing musculoskeletal pain, reviewers wanted to examine the effectiveness of the topical variety for managing pain for longer than 8 weeks. And while they have been widely used for years in some parts of the world, topical NSAIDs have been slow to become popular in the U.S.
A team of reviewers evaluated 34 studies involving 7,688 adults with chronic musculoskeletal pain for a period of at least 3 months. Participants were organized into groups using either a topical NSAID applied at least once daily, such as diclofenac, ketoprofen, indomethacin, and ibuprofen; a placebo; or an oral NSAID.
The reviewers found the topical NSAID diclofenac was as effective as oral NSAIDs for arthritis in the knee or hand and it gave more participants good pain relief compared to the placebo in studies lasting 8–12 weeks. In four studies, for example, diclofenac gave 60 percent of participants' pain relief over 8–12 weeks compared to 50 percent of those in the placebo group.
Lead reviewer Sheena Derry, Ph.D., of the Pain Research and Nuffield Department of Clinical Neurosciences at the University of Oxford in the U.K., explained, however, that the use of topical formulations is limited to conditions where the pain is "near to the surface."
"The benefit of topical over oral NSAIDs is that with topical, the drug stays close to the site of application, so levels in blood and more remote tissues remain very low," said Derry. "This means you don't get the gastrointestinal problems that are associated and cause so many problems with oral NSAIDs."
Roger Chou, M.D., an assistant professor of medicine at Oregon Health & Science University and expert in pain management, said the review findings were similar to his past research and were consistent with what he'd expect to see.
"I think one thing to remember is that for topical medications to work, [the pain] has to be fairly localized," said Chou. "It would be tough to use these NSAIDs for fibromyalgia where the pain is all over the body, or back pain, where the pain is typically in the deeper structures."
Chou added that there are many reasons why topical NSAIDs have been slow to gain usage in the U.S., partly because the U.S. Food Administration only approved the first formulations in 2007.
"I also think that many patients and clinicians simply perceive topical NSAIDS to be weaker than pills," Chou said. "But as we learn more about their effectiveness and perhaps as the cost comes down, people will use them more."
More information: Derry S, Moore RA, Rabbie R. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2012, Issue 9.
Journal reference: Cochrane Library
Provided by Health Behavior News Service
- Topical treatments provide effective local pain relief Jun 15, 2010 | not rated yet | 0
- NSAIDs are effective for short-term relief of low-back pain Jan 23, 2008 | not rated yet | 0
- NSAIDs may be more effective than paracetamol for period pain Jan 20, 2010 | not rated yet | 0
- Etoricoxib provides long lasting pain relief after surgery Apr 15, 2009 | not rated yet | 0
- Muscle rubs: Use for pain is questionable Jul 08, 2009 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Assumptions of Griffith's fracture theory
5 hours ago Any experts on Griffith's fracture theory? I am studying the subject and I am having hard time finding out if the theory is valid for all possible...
Current leading voltage or vice versa concept
6 hours ago Hello, I was wondering if there is a conceptual explanation for when current leads voltage or vice versa for capacitors or inductors with AC...
Angular Frequency of AC voltage
9 hours ago Hello, I am wondering, what is the physical interpretation of the angular frequency of AC voltage? I don't see the physicality of what the angle...
Modeling Rigid Body - Unsure about Euler angles and angular velocity
10 hours ago I'm modeling a single 3D rigid body in preparation for some more complicated modeling in order to gain a better understanding of Euler angles, the...
Function for a bullet's path
11 hours ago I've been mulling this over all weekend, and I've decided to get some help on this. The problem is writing a function to describe a bullet's path....
Elementary questions relating to Newton's laws of motion
12 hours ago i) If a wall breaks when it gets hit by a cannonball, did the wall exert an equal and opposite force on the cannonball? ii) Would the force...
- More from Physics Forums - Classical Physics
More news stories
(HealthDay)—Injections of a sugar solution appear to help relieve knee pain and stiffness related to osteoarthritis, a new study suggests.
Arthritis & Rheumatism 3 minutes ago | not rated yet | 0 |
A novel study reports that white men and women of European descent inherit common foot disorders, such as bunions (hallux valgus) and lesser toe deformities, including hammer or claw toe. Findings from the Framingham Foot ...
Arthritis & Rheumatism May 20, 2013 | not rated yet | 0 |
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
Arthritis & Rheumatism May 19, 2013 | 4.8 / 5 (6) | 0 |
(HealthDay)—Compared to clinical diagnosis of synovitis, ultrasound-detected synovitis provides either improved sensitivity or specificity when used with the American College of Rheumatology/European League ...
Arthritis & Rheumatism May 15, 2013 | not rated yet | 0
(HealthDay)—A genome-wide linkage scan has identified the chromosome 17p11.2-q11.2 region as the susceptibility locus for fibromyalgia, according to research published in the April issue of Arthritis & ...
Arthritis & Rheumatism May 11, 2013 | not rated yet | 0
(Medical Xpress)—Scientists at the School of Medicine have shown that their previously identified therapeutic approach to fight cancer via immune cells called macrophages also prompts the disease-fighting killer T cells ...
12 minutes ago | not rated yet | 0 |
Over the past few decades, scientists have developed many devices that can reopen clogged arteries, including angioplasty balloons and metallic stents. While generally effective, each of these treatments ...
7 minutes ago | not rated yet | 0 |
(HealthDay)—When it comes to the care of your children's teeth, dentists aren't the only experts who can help.
13 minutes ago | not rated yet | 0
(Medical Xpress)—Exposure to sunshine as a small child is crucial to the development of a healthy eye according to results of long-term myopia study conducted by University of Sydney researchers.
53 minutes ago | not rated yet | 0
(HealthDay)—For patients with acute respiratory distress syndrome (ARDS), prolonged prone positioning during mechanical ventilation is associated with significantly reduced mortality at 28 and 90 days, ...
33 minutes ago | not rated yet | 0
(AP)—Tunisia's Health Ministry says a 66-year-old man has died after being infected by the new coronavirus following a visit to Saudi Arabia.
12 minutes ago | not rated yet | 0