Following on from my last article on the risks associated with the use of common over the counter anti-inflammatory medications, I wanted to see what the other options were and more importantly, how effective they are. I found an article which compared the results of 47 different studies on the effectiveness of different forms of ‘non tablet’ anti-inflammatories, ie gels, sprays, and creams. The attraction of these options is that there are none of the associated systemic adverse events.

The results of 47 studies were included. In these studies, the gels/creams/sprays were compared to placebo gels/creams/sprays; overall the effects on 3455 people were analysed. They found the following:

• The number of applications required to get a pain reduction of 50% was 4.5
• Topical diclofenac, ibuprofen, ketoprofen, and piroxicam were of similar efficacy
• Indomethacin and benzydamine were not significantly better than placebo
• Local skin reactions were generally mild and transient, and did not differ from placebo.
• There were very few systemic adverse events or withdrawals due to adverse events.

AUTHORS’ CONCLUSIONS: Topical NSAIDs can provide good levels of pain relief, without the systemic adverse events associated with oral NSAIDs, when used to treat acute musculoskeletal conditions.

In short, they seem to be a viable alternative.

Full article: http://www.ncbi.nlm.nih.gov/pubmed/20556778?dopt=Abstract