Arthritis in Podiatry
Some topical non-steroidal drugs are available without prescription and are widely advertised for acute and chronic painful conditions. There are 20–24 million prescriptions (predominantly oral) for non-steroidal anti-inflammatory drugs in the United Kingdom each year, 5% of the NHS total prescriptions. The attributable risk of going to hospital with gastrointestinal problems is 1.3 to 1.6% annually for regular users of oral non-steroidals. This raises the question of whether for some patients using oral non-steroidal anti-inflammatory drugs is worse than the disease. Despite licensed status, there is skepticism that topical non-steroidal anti-inflammatory drugs have any action other than as rubefacients.
The following article concludes: “Topical non-steroidal anti-inflammatory drugs are effective in relieving pain in acute and chronic conditions.”
BMJ. 1998 Jan 31;316(7128):333-8
The following article reports “The systemic concentrations of ketoprofen have also been found to be 100-fold lower compared to tissue concentrations below the application site in patients undergoing knee joint surgery. Topically applied ketoprofen thus provides high local concentration below the site of application but lower systemic exposure.”