But if you have a history of ulcers or gastrointestinal bleeding, the medicine in the drug travels through your blood and can still put you at risk. Using topical NSAIDs may help you avoid stomach upset. Altman, MD, professor of medicine in the division of rheumatology and immunology at the University of California, Los Angeles. You are older than 65. “A lot of elderly patients can’t take oral NSAIDs because they have stomach or heart risk factors, and they can’t take narcotic analgesics because they could become so drowsy they could fall and break a bone,” says Roy D.They work best on joints that are closer to the surface, such as the hands, knees, elbows and ankles. Topical NSAIDs penetrate the skin and help reduce pain locally. These gels, liquids or patches may work for you if: This could raise the price and insurance may not reimburse you for the medicine. Other NSAIDs, such as ibuprofen, ketoprofen, indomethacin and piroxicam can be made into topical solutions at a compounding pharmacy. When used for osteoarthritis knee pain, apply 40 mg (2 pumps) on each painful knee, 2 times a day. Diclofenac sodium 2% liquid ( Pennsaid).Dispense in 10-drop portions to prevent spilling. When used for osteoarthritis knee pain, apply 40 drops per knee, 4 times a day. Diclofenac sodium 1.5% liquid ( Pennsaid).Apply one patch to your most painful joint twice per day. Diclofenac epolamine 1.3% patch ( Flector).A dosing card comes with the gel so you can measure the correct amount. However, the total amount used on your body should not exceed 32 grams per day. When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). Diclofenac sodium 1% gel ( Voltaren Arthritis Pain, now available as an OTC).However, a 2016 Cochrane review looked at 39 studies with 10,631 participants and found that only about 10% more people get OA pain relief from topical diclofenac than from placebo. So they may not provide sufficient relief for everyone, but it's a good idea to try them before oral medications, and they are a good option for those who can't or don't want to take oral NSAIDs. And authors of a 2021 systematic review and meta analysis in The Physician and Sportsmedicine conclude, "It should be recommended to patients as a first-line conservative management for OA of the knee." The American College of Rheumatology recommends topical a NSAID as a first treatment for osteoarthrtis (OA) pain, especially of the knees. Different strengths are available for different purposes. Until 2020 it was available only by prescription, but can now be purchased over the counter. are available as gels, liquids and patches. A topical NSAID, like other kinds of topicals, can be rubbed on the skin over sore joints to relieve pain, without the stomach upset or cardiovascular risks of oral medication.įirst approved in the United States in 2007, topical formulations of diclofenac - the only topical NSAID product commonly available in the U.S. If you have arthritis in just a couple of your joints, you may not need to expose yourself to the risks of oral nonsteroidal anti-inflammatory drugs (NSAIDs) to get some relief.
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