Topical NSAIDs and capsaicin for osteoarthritis
Bannuru, 2019Kloppenburg, 2019Kroon, 2014Sakellariou, 2017
The approach to managing osteoarthritis, and the role of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and capsaicin for pain relief, is described in Components of management for osteoarthritis.
Topical NSAIDs and capsaicin can be considered as an adjunct to other treatment strategies and as part of short-term self-management.
Topical NSAIDs have been shown to have a small benefit in pain relief compared to topical placebo preparations in studies up to 12 weeks, mainly in patients with knee osteoarthritis. Because of minimal systemic absorption, topical NSAIDs are considerably safer than oral NSAIDs in patients with osteoarthritisDerry, 2016. If a trial of a topical NSAID is considered appropriate for pain associated with osteoarthritis, use:
1diclofenac 1% gel applied to the painful area, up to 4 times daily diclofenac diclofenac diclofenac
OR
1diclofenac 2% gel applied to the painful area, once or twice daily diclofenac diclofenac diclofenac
OR
1ibuprofen 5% gel applied to the painful area, up to 4 times daily ibuprofen ibuprofen ibuprofen
OR
1piroxicam 0.5% gel applied to the painful area, up to 4 times daily. piroxicam piroxicam piroxicam
Topical capsaicin has also been shown to have a small benefit in pain relief compared to topical placebo preparations in short-term studies in patients with knee osteoarthritis. The main adverse effect limiting use is a transient burning at the site of application. Capsaicin is not recommended for hand or hip osteoarthritis. If a trial of topical capsaicin is considered appropriate for pain associated with osteoarthritis, use: