LAUSR

Chronic musculoskeletal pain (CMP), pain lasting greater than 3 months or past the time of normal tissue healing, is a prevalent condition and a major cause of disability and absence from work worldwide (Centers for Disease Control and Prevention, 2016; Santos, Alarcao, Fareleira, Vaz-Carneiro, & Costa, 2015 ; Wall, 2016). Oftentimes, topical nonsteroidal antiinfl ammatory drugs (NSAIDs) are prescribed to treat chronic musculoskeletal conditions with the anticipation that they will relieve a patient’s pain and infl ammation while minimizing the side effects experienced if prescribed by other routes, achieving a balance of effi cacy and safety. This has not been without controversy in analgesic practice ( Derry, Conaghan, Da Silva, Wiffen, & Moore, 2016 ). NSAIDs are commonly prescribed as a fi rst-line therapy, as a nonopioid analgesic, for people with substance use disorders, the elderly, as well as to reduce gastrointestinal adverse events commonly experienced with oral administration. (AAPM, 2009; Derry, Moore, Gaskell, McIntyre, & Wiffen, 2015 ; Savage, Kirsh, & Passik, 2008 ). How effective is this form of pharmacological management? Topical NSAIDs are produced for application on a superfi cial localized site and may not be indicated for deep visceral pain or deep-seated join pain. Are our patient’s pain management needs being met when topical NSAIDs are prescribed for CMP? Join me in this commentary, as we examine the effi cacy of commonly prescribed topical NSAIDs for the treatment of CMP by way of summarizing Derry et al.’s (2016) review of “Topical NSAIDs for Chronic Musculoskeletal Pain in Adults.” Let’s see what the evidence says.