TY - JOUR T1 - Topical NSAIDs provide effective relief of acute musculoskeletal pain compared to placebo, with no increase in risk of adverse effects JF - Evidence Based Nursing JO - Evid Based Nurs SP - 23 LP - 24 DO - 10.1136/ebn1126 VL - 14 IS - 1 AU - Debra B Gordon Y1 - 2011/01/01 UR - http://ebn.bmj.com/content/14/1/23.abstract N2 - Commentary on: Massey T, Derry S, Moore RA, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev 2010;6:CD007402. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for acute and chronic inflammatory painful conditions. NSAIDs produce analgesia by inhibition of the enzyme mediating production of prostaglandins and thromboxane.1 Systemic administration of NSAIDs produces relatively high blood concentrations that can lead to serious adverse events including gastrointestinal bleeding, renal failure and precipitation of congestive heart failure and other cardiovascular events.2 ,3 Topical application may reduce these risks by avoiding circulation to all parts of the body that accompany oral, rectal and intravenous administration. Topical formulations have limited tissue penetration with minimal uptake into the systemic circulation. This route is indicated for superficial and well-defined areas with intact skin and is not appropriate for deeper structures (eg, spine or organs). Unlike compounded creams, gels and sprays, topical formulations are … ER -