TY - JOUR T1 - Topical NSAIDs provide effective relief of acute musculoskeletal pain compared to placebo, with no increase in risk of adverse effects JF - Evidence Based Medicine JO - Evid Based Med SP - 177 LP - 178 DO - 10.1136/ebm1124 VL - 15 IS - 6 AU - Rachelle Buchbinder Y1 - 2010/12/01 UR - http://ebm.bmj.com/content/15/6/177.abstract N2 - Commentary on: Massey T, Derry S, Moore RA, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev 2010;6:CD007402. Acute musculoskeletal pain due to sprains and strains and sporting injuries are a common occurrence. Usual treatment includes rest, ice, compression and elevation; simple analgesia, oral non-steroidal anti-inflammatory drugs (NSAIDs); and various over-the-counter or prescription topical NSAIDs and rubefacients. In evaluating the evidence for the efficacy and safety of topical NSAIDs for acute musculoskeletal pain, Massey and colleagues identified randomised double-blind trials in adults (16 years or older) that compared topical NSAIDs, applied at least once daily, with placebo or an active treatment. Trials were included only if there were at least 10 participants per arm, outcomes were measured close to 7 days and if they provided data for the primary outcome of ‘clinical success’ defined as a 50% reduction in patient-reported pain or equivalent categorical measure. Secondary outcomes were number of patients with adverse events (local and systemic) and number of withdrawals (all causes, due to lack of efficacy and adverse events). Data sources used to identify relevant trials included MEDLINE, EMBASE, Cochrane CENTRAL, … ER -