People with arthritis pain often find themselves caught between two terrible alternatives: suffer the pain, or suffer the side effects of the usual pain relievers. NSAIDS can have some serious drawbacks, as we have discussed.
So, it is always good to find ways to alleviate the discomfort and minimize the untoward consequences. One possibility that people often overlook is a topical pain reliever.
Using a Topical Pain Reliever for Knee Pain:
Q. I have severe osteoarthritis of the knee and used Celebrex with fair results. My doctor then prescribed a compounded topically applied medicine containing ketoprofen in a 20 percent gel.
It has been very effective in relieving my knee pain, particularly at rest when the pain would “pulse” uncomfortably. The relief occurs around 20 minutes after applying the gel.
I was doubtful at first that any topically applied drug would help, but believe me, it really does. Why isn’t this treatment better known?
Finding a Topical Pain Reliever:
A. Topical NSAIDs (nonsteroidal anti-inflammatory drugs) are creams or gels containing a drug such as ketoprofen or diclofenac (Pennsaid, Voltaren Gel). These can be applied directly to the sore joint. They have been used successfully in Europe, Canada, Australia and New Zealand for years. In placebo-controlled trials, topical NSAIDs are about as effective as oral NSAIDs for alleviating arthritic knee pain (Journal of Family Practice, Feb. 2015).
In addition to offering comparable pain relief, topical ketoprofen gel resulted in few digestive tract side effects (Sardana et al, Musculoskeletal Care, online Oct. 24, 2016). A Cochrane Library review of 39 studies following strict criteria found that both ketoprofen and diclofenac provide “good levels of pain relief” as topical medicines (Derry et al, Cochrane Database of Systematic Reviews, April 22, 2016).
Although Voltaren Gel is available in some countries over the counter, in the US it requires a prescription. Please be aware that occasionally people develop allergic contact dermatitis in reaction to this compound (Gulin & Chiriac, Drug Safety – Case Reports, Dec. 2016).
Cautions for Pet Owners:
If your doctor is prescribing for a compounding pharmacy, please be aware that the NSAID flurbiprofen that may be used in some formulations is very toxic to cats. The FDA recently issued this alert. People with pets will want to take precautions against allowing the animals to be exposed in any way to their topical NSAID pain medication.
To learn more about these medications and other options for managing joint pain, you may want to read our Guide to Alternatives for Arthritis.
Revised 2/27/2017
