Cochrane Database of Systematic Reviews has reported that topical nonsteroidal anti-inflammatory drugs may be safe and effective for acute musculoskeletal conditions in adults
The use of topical NSAIDs vary in different countries.In theory they have potential to provide pain relief without associated systemic adverse events.”
Recent report published on June 16,2010 has evaluated the evidence from randomized, double-blind, controlled trials of the efficacy and safety of topically applied NSAIDs for relief of acute pain.
It was found that all topical NSAIDs like diclofenac, ibuprofen, ketoprofen, and piroxicam were effective but indomethacin and benzydamine were not significantly more effective than placebo.
There were very few systemic adverse events or adverse events causing study withdrawals, and local skin reactions were usually mild, self-limited, and not different from those seen with placebo.
The study concluded
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 adults.
Topical NSAIDs have always been controversial for use in musculoskeletal pains. Recent study consisting of systematic review has provided good evidence for rationale of use of topical NSAIDs in acute musculoskeletal problems.