True or False poll no. 68
Canadian Agency for Drugs and Technologies in Health (CADTH)
TRUE or FALSE:
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) have been proven to be as effective as opioids in treating acute musculoskeletal pain.
FALSE
Although a recent review by the Canadian Agency for Drugs and Technologies in Health (CADTH) found that topical nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for reducing acute musculoskeletal pain from sprains, strains or sports injuries compared to placebo, no evidence was found that compared their effectiveness to the effectiveness of opioids.
Acetaminophen, NSAIDs and opioids are the recommended first-line treatments for acute musculoskeletal pain but are associated with increased health risks. Opioid use disorder is also an increasing concern in Canada, making alternative treatments for acute musculoskeletal pain of interest.
Topical NSAIDs, one possible alternative to opioids and other pain medications, are applied directly to an injury, circumventing systemic absorption and allowing for a lower, potentially safer dosage.
However, a review of the evidence did not find any studies that compared the use of topical NSAIDs to opioids, the effect of their combined use or the effect of the use of topical NSAIDs on reducing opioid use or dosage. Therefore, despite the evidence showing that topical NSAIDs are more effective than placebo in treating acute musculoskeletal pain, more high-quality evidence that compares the use of opioids with the use of topical NSAIDs is needed for a better understanding of their roles in the management of acute musculoskeletal pain.
The CADTH review assessed the clinical evidence based on four relevant publications: three systematic reviews and meta-analyses, and one randomized controlled trial.
Read more about the CADTH review of topical NSAIDs versus opioids for acute musculoskeletal pain at www.cadth.ca/topical-nsaids-versus-opioids-acute-musculoskeletal-pain-review-clinical-effectiveness-0