Will topical NSAIDs help with chronic musculoskeletal pain?

Cochrane review: Derry S, Conaghan P, Da Silva JAP, Wiffen PJ, Moore RA. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2016, Issue 4.

The Problem: Chronic musculoskeletal pain affects many people. The most common condition causing chronic musculoskeletal pain is osteoarthritis. NSAIDs as a gel or solution applied directly to the site is recommended as a potential form of pain relief.¹ However, the effectiveness of these topical treatments has often been questioned. Studies have shown that a placebo gel or solution often has similar effects to that of the NSAID. This is thought to be due to a bio-lubrication mechanism.² This Cochrane review was designed to answer the question as to whether topical NSAIDS really do help with superficial musculoskeletal pain.

Clinical Bottom Line: This Cochrane review showed that topical NSAIDs did reduce pain by more than 50% in significantly more participants than placebo treatments.³ The placebo effect was very strong with half the participants in the placebo group reporting significantly reduced pain. Dry skin was reported by some participants but there were no serious systemic adverse events reported.³