Non-steroidal anti-inflammatory (NSAID) medication, such as ibuprofen and diclofenac, and a newer one called celecoxib (which we wrote about yesterday, have been prescribed as oral medications for the treatment of arthritis pain.

There are some concerning side effects from oral NSAIDs which includes stroke, heart attack, and bleeding or ulceration on the stomach or intestines.

The United States Food and Drug Administration has now approved a topical NSAID for treatment of osteoarthritis pain. Voltaren® Gel is the first approved topical treatment which is applied directly to the area of the osteoarthritis pain.

Over-the-counter remedies, like Bengay and Icy Hot, work primarily by generating heat or numbing the area. Voltaren® Gel contains diclofenac which is the most commonly used NSAID in the world and the second most commonly used NSAID in the U.S.

Two randomized, double-blind, placebo-controlled studies were conducted involving over 900 patients. The first, on patients with osteoarthritis of the hand, showed a 46% reduction in pain after 6 weeks of treatment. The other study was on patients with knee osteoarthritis. After 12 weeks these participants reported a 51% reduction in pain.

This type of topical NSAID pain reliever has been available in other countries for some time. These have provided additional supporting research.

The British Medical Journal reviewed 13 clinical trials of topical NSAIDs and found that in the first week they were less effective than a comparable oral treatment but were equivalent in pain reduction from the 2nd to 4th weeks.

Tests have also shown that there is less drug absorption throughout the body than oral medications. For example, there is 94% less absorption than with a comparable oral diclofenac treatment.

Patients with osteoarthritis pain in multiple locations will most likely still need to use an oral NSAID.

Over-the-counter remedies, like Bengay and Icy Hot, work primarily by generating heat or numbing the area.

Novartis, the maker of Voltaren® Gel, indicates that it should not be taken by patients with a known hypersensitivity to diclofenac, or who have experienced asthma or allergic type reactions to aspirin of other NSAIDs. They also say that it should not be used in combination with aspirin or other oral NSAIDs due to potential side effects.

This report is not intended to be an endorsement of Voltaren® Gel. Rather, it is intended to provide information about an alternative treatment for osteoarthritis pain. You should always consult your physician before beginning any new prescription treatment.