Clinical question
How effective are salicylate-containing topical rubefacients for acute and chronic musculoskeletal pain in adults?
Bottom line
Compared with placebo, there was very little evidence of efficacy for salicylate-containing topical rubefacients in acute or chronic pain. Acute conditions were mainly sprains, strains and acute low-back pain; chronic conditions were mainly osteoarthritis, bursitis and chronic back pain. Any evidence of efficacy came from the older, smaller studies, while the larger, more recent studies showed no effect. Adverse events were more common with salicylates than with placebo.
Caveat
Evidence for any benefit was limited by the quality, validity and size of the available studies.
Context
Rubefacients containing salicylates cause irritation of the skin and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies.
Cochrane Systematic Review
Derry S et al. Salicylate-containing topical rubefacients for acute and chronic musculoskeletal pain in adults. Cochrane Reviews, 2014, Issue 11. Art. No.: CD007403.DOI: 10.1002/14651858. CD007403.pub3. This review contains 14 studies involving 1368 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
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