Topical NSAIDs in Musculoskeletal Pain – More Than Placebo?

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Andreas Sönnichsen

QuestionPatients with musculoskeletal pain often ask for a prescription of “pain-ointments” like Diclofenac-gel or other topical NSAIDs which are not reimbursed by statutory public health insurance in Germany. This raises the question whether there exist any clinical studies which investigated the therapeutic effect of these topical applications of NSAIDs or whether we have any evidence for a relevant therapeutic effect. AnswerTopical NSAIDs are effective in the treatment of various muskuloskeletal disorders. The best data are available for (sports-)injuries, sprained ankle and osteoarthritis of the knee, but some studies also show good effects in neck, muscular and other localized pain as well as tendinitis. It is surprising that there does not exist a single randomized controlled study evaluating the effect of topical NSAIDs in unspecific low back pain. Although there is no study evidence, from a practical viewpoint it seems justified to try out topical NSAIDs in low back pain as well, if this helps to avoid a prescription of oral NSAIDs.

(State: 15.01.2019)

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