Do topical anti-inflammatory medications work for acute musculoskeletal pain?
Anti-inflammatories (nonsteroidal anti-inflammatory drugs) such as pain relief gel rubs and sports rubs are commonly used topically for acute and/or persistent musculoskeletal pain. A comprehensive literature review published in 20151 looked at whether these anti-inflammatories really do provide relief.
The types of medications in the study included diclofenac, ibuprofen, ketoprofen, piroxicam, and indomethacin. Generally these medications were well tolerated when used topically and did not seem to cause significant stomach upset, a common complaint with oral anti-inflammatory medication.
Topical anti-inflammatory medications are applied to unbroken skin and the review indicates they do in fact penetrate into the tissues. The levels of the drugs in the blood when the medication is applied topically are much lower than when the drug is taken orally. When a typical dose of topical anti-inflammatory medication is administered, the low level of medication found in the blood ensures less chance of a subsequent stomach upset. Furthermore, when the gel is applied at least once a day, the study found a reduction in pain of about half.
It seems that gel formulations are most effective for use in musculoskeletal pain. It is important to note that if taking oral anti-inflammatory and using the topical anti-inflammatory rubs the drug will be entering your system twice. Remember to always discuss medications with your treating doctor.