479 Topical rubefacients ineffective for musculoskeletal pain

February 04, 2016

written by Brian R McAvoy

Clinical question
How effective are salicylate-containing topical rubefacients for acute and chronic musculoskeletal pain in adults?

Bottom line
Compared with placebo, there was very little evidence of efficacy for salicylate-containing topical rubefacients in acute or chronic pain. Acute conditions were mainly sprains, strains and acute low-back pain; chronic conditions were mainly osteoarthritis, bursitis and chronic back pain. Any evidence of efficacy came from the older, smaller studies, while the larger, more recent studies showed no effect. Adverse events were more common with salicylates than with placebo.

Evidence for any benefit was limited by the quality, validity and size of the available studies.

Rubefacients containing salicylates cause irritation of the skin and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies.

Cochrane Systematic Review
Derry S et al. Salicylate-containing topical rubefacients for acute and chronic musculoskeletal pain in adults. Cochrane Reviews, 2014, Issue 11. Art. No.: CD007403.DOI: 10.1002/14651858. CD007403.pub3. This review contains 14 studies involving 1368 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.