Study shows anti-inflammatory skin gels just as effective as oral tablets for chronic knee pain

Research from the University of Warwick’s Medical School suggests applying anti-inflammatory gels or creams to the skin may be a useful alternative to taking them orally.

In a paper published this week in the British Medical Journal (January 19, 2008), Professor Martin Underwood, Professor of Primary Care Research and Vice Dean at Warwick Medical School, reported the results of a trial to determine whether older patients with chronic knee pain should be advised to use topical or oral non-steroidal anti-inflammatory drugs (NSAIDs).

Around a third of people aged over 50 years have chronic knee pain and both oral and topical anti-inflammatory drugs are used to treat this and both have short-term beneficial effects. This two-year trial recruited patients with chronic knee pain aged 50 and over from 26 general practices in the UK. Patients completed postal questionnaires at three, six, 12 and 24 months after study entry. There were also nurse assessments and blood tests at 12 and 24 months.

The researchers noted there were no significant differences between patients using anti-inflammatory creams on the skin or oral tablets. In his paper, Professor Underwood said: “Participants who wanted a choice predominantly selected topical rather than oral medication, although those with more severe or widespread pain chose oral rather than topical medication.”

Professor Underwood added that the study revealed the decision to prescribe oral or topical drugs was often affected by patient choice. Results showed more widespread or chronic pain was perceived by patients to be ‘more serious’ and to require oral medication


Professor Martin Underwood’s paper, Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study, can be accessed online at:

For more information, contact Kelly Parkes, Communications Officer,

Warwick Medical School,,

0247 615 0483, 07824 540863

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