NMA: Nonprescription Medicines Academy

Little Evidence to Support Use of Topical Salicylates

August 31st, 2009

A recent Cochrane systematic review found little evidence supporting the use of topical rubefacients for musculoskeletal pain in adults

The review included a total of 16 controlled studies that evaluated the use of topical salicylates for acute pain conditions such as strains and sprains (7 studies involving 697 patients) or chronic pain conditions such as osteoarthritis (9 studies involving 579 patients). There was no difference between topical rubefacient and control in the better-quality studies of acute pain conditions; when all of the studies were included, the number needed to treat (NNT) for benefit compared with placebo was 3.2 (95% CI, 2.4 to 4.9). The NNT in chronic conditions was 6.2 (95% CI, 4.0 to 13), which compares poorly with the efficacy of topical NSAIDs.

The limited data available do show that topical salicylates are relatively well tolerated in the short-term.
Cochrane Database Syst Rev. 2009 Jul 8;(3):CD007403

Author: Cynthia Knapp Dlugosz, BPharm