Q. I understand that NSAID patches are used in Europe to treat some kinds of arthritis. Are they available in the United States?
A. It would be nice if arthritis pains could be eliminated by a cream, ointment or patch, wouldn’t it?
It’s true that several topical nonsteroidal anti-inflammatory drugs (NSAIDs) are available without prescription in Europe, but they really haven’t caught on in the U.S. That may be because high-quality, long-term studies of benefits and risks are lacking.
These medicines are used to treat pain from strains, sprains, and sports injuries, as well as conditions such as osteoarthritis and rheumatoid arthritis. Some of these topical NSAIDs have been shown to be at least modestly effective, and to cause less heartburn and other gastrointestinal symptoms than the same drugs taken by mouth.
At least one topical NSAID has been available in the U.S. for many years: salicylate, the active ingredient in aspirin, is found in Aspercreme and Nuprin. And another was recently approved by the FDA: the Flector Patch contains the NSAID diclofenac, the same active ingredient contained in the oral NSAID Voltaren.
Topical NSAIDs have some obvious advantages, especially for localized muscle, tendon, or joint pain. The medication is concentrated in the tissue where it is applied, and therefore is less likely to cause side effects elsewhere in the body. However, it’s not clear that these medicines are actually able to penetrate through the skin to reach the source of pain. The long-term effects of these drugs still need to be explored. Regular long-term use may raise levels of the drug in the bloodstream and cause gastrointestinal symptoms. For now, NSAID patches are designed for local pain relief, not systemic treatment.
Although topical NSAIDs haven’t been wholeheartedly embraced in the United States, that could soon change as drug companies are working to develop new NSAID patches. But it will take additional research before that happens.
While it’s hard to say for sure, someday you could have a choice of several NSAID patches for your aches and pains.
What do you find helps your arthritis? I’d like to hear what’s working for you.
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Comments: 7
Topical preparations that cool the skin (often due to their content of alcohol, menthol, or camphor) can provide some relief from arthritis pain, perhaps by interrupting pain signals running through the skin or just below the skin. I am not familiar with Salonpas so I looked it up: it contains Salicylate (the active ingredient in aspirin), menthol, Camphor and vitamin E. So, it's a combination NSAID patch/cooling topical treatment/anti-oxidant for the skin. Whether any of these topical treatments, glucosamine, chondroitin or MSM reliably work well (alone or in combination) is a matter of some debate. A recent study suggested chondroitin alone has little benefit for common types of arthritis.
You're fortunate if these measures seem to be helping you and if they are not causing you any harm. If you haven't already, it's a good idea to let your doctor know you are taking them and to be monitored regularly. Good luck!