Systematic review of efficacy of topical rubefacients containing salicylates for the treatment of acute and chronic pain

Mason, Lorna; Moore, Richard A.; Edwards, Jayne E; McQuay, Henry J; Derry, Sheena; Wiffen, Philip J

doi:10.1136/bmj.38040.607141.ee

Cited by 99 publications

(54 citation statements)

References 24 publications

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“…In acute conditions the NNT was 2.1; in chronic conditions the NNT was 5.3. It was concluded that topical salicylates may have efficacy in acute pain at seven days, but poor to moderate efficacy for chronic pain at 14 days (250). Table 18 presents the topical NSAIDs and some of the rubefacients available in Canada.…”

Section: Topical Analgesicsmentioning

confidence: 99%

The Pharmacotherapy of Chronic Pain: A Review

Lynch

Watson

2006

Pain Research and Management

103

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The past two decades have contributed a large body of preclinical work that has assisted in our understanding of the underlying pathophysiological mechanisms that cause chronic pain. In this context, it has been recognized that effective treatment of pain is a priority and that treatment often involves the use of one or a combination of agents with analgesic action. The current review presents an evidence-based approach to the pharmacotherapy of chronic pain. Medline searches were done for all agents used as conventional treatment in chronic pain. Published papers up to June 2005 were included. The search strategy included randomized, controlled trials, and where available, systematic reviews and meta-analyses. Further references were found in reference sections of papers located using the above search strategy. Agents for which there were no controlled trials supporting efficacy in treatment of chronic pain were not included in the present review, except in cases where preclinical science was compelling, or where initial human work has been positive and where it was thought the reader would be interested in the scientific evidence to date.Key Words: Anticonvulsants; Antidepressants; Cannabinoids; Chronic pain; Opioids; Pharmacotherapy; Topical analgesics La pharmacothérapie de la douleur chronique : Une analyse Les deux dernières décennies ont contribué à un vaste ensemble de travaux précliniques qui nous ont permis de mieux comprendre les mécanismes physiopathologiques sous-jacents responsables de la douleur chronique. Dans ce contexte, il est admis que le traitement efficace de la douleur est une priorité et qu'il exige souvent le recours à un agent ou à une association d'agents ayant une action analgésique. La présente analyse présente une démarche probante de la pharmacothérapie de la douleur chronique. Des recherches dans Medline ont été effectuées sur tous les agents utilisés pour le traitement classique de la douleur chronique. Les articles publiés jusqu'en juin 2005 ont été inclus. La stratégie de recherche incluait les essais aléatoires et contrôlés et, si elles étaient disponibles, les analyses systématiques et les méta-analyses. D'autres références ont été obtenues dans la partie des références des articles trouvés à l'aide de la stratégie de recherche précédente. Les agents dont aucun essai contrôlé n'étayait l'efficacité pour le traitement de la douleur chronique étaient exclus de la présente analyse, sauf si les données scientifiques précliniques étaient convaincantes, si les travaux humains initiaux étaient positifs ou si on pensait que les données scientifiques colligées jusque-là étaient intéressantes pour le lecteur.

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Section: Topical Analgesicsmentioning

confidence: 99%

The Pharmacotherapy of Chronic Pain: A Review

Lynch

Watson

2006

Pain Research and Management

103

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“…Additionally their efficacy may be over-estimated as adequate blinding is not possible with any trial involving a rubefacient, the mechanism of action is through local irritation and any sham preparation, which attempts to mimic this, would be a rubefacient itself. However, placebo gels in trials were rubbed on to the skin in the same way as the active treatment overcoming any additional therapeutic effect of rubbing (52).…”

Section: Topical Counter-irritantsmentioning

confidence: 99%

“…Based on limited data, rubefacients appear well tolerated and local adverse effects are uncommon in the short term (2% of patients) (51,52). Currently they are usually used as adjuvants to other therapies, such as oral analgesics, support bandages, rest, ice, and compression, and may be useful for patients who cannot tolerate oral analgesics (52).…”

Section: Topical Counter-irritantsmentioning

confidence: 99%

Topical and Regional Treatment for Osteoarthritis

Patel¹,

Mackworth‐Young²

2012

Osteoarthritis - Diagnosis, Treatment and Surgery

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“…Muscle relaxants are typically recommended as adjuvant therapy and seem to have a restricted role in the treatment of chronic, non-cancer pain [22,23]. Topical agents have also been shown to effectively reduce chronic pain in comparison to placebo [24].…”

Section: Pharmacological Treatmentsmentioning

confidence: 99%

A Review of the Common Factors Model and Its Application in Pain Management

Coghill¹

2016

IJCAM

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Pain management providers in the field tend to be eclectic and flexible in their choice of modalities and attempt different treatments until they find something that suits the patient, a phenomenon known as the "Goldilocks effect" which derives from the children's story The Story of the Three Bears. Research studies in pain management have concluded that the diverse treatment interventions currently available all appear to be equivocally effective. In the past, the practice of psychotherapy confronted a similar issue--research studies concluded that all psychotherapies were effective which led to a verdict later termed the "Dodo bird effect" referencing a scene from Alice's Adventures in Wonderland. This conclusion led to the distinction of two possible mechanisms of psychotherapeutic change, specific versus non-specific effects, also known as "common factors." The purpose of the current review is to outline the applicability of the common factors model to pain management and provide supportive evidence from existing research.

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Systematic review of efficacy of topical rubefacients containing salicylates for the treatment of acute and chronic pain

Cited by 99 publications

References 24 publications

The Pharmacotherapy of Chronic Pain: A Review

The Pharmacotherapy of Chronic Pain: A Review

Topical and Regional Treatment for Osteoarthritis

A Review of the Common Factors Model and Its Application in Pain Management

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