• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

Table 7.30Symptoms: pain

Pain outcomeReferenceInterventionAssessment timeOutcome/effect size
Knee osteoarthritis
WOMAC pain1 MA (Towheed 2006) 3 RCTs (N=697)Topical diclofenac vs placeboEnd of treatmentSMD −0.33, 95% CI −0.48 to −0.18, p<0.0001
Favours topical Pennsaid
WOMAC pain at end of treatment1 MA (Towheed 2006) 1 RCT (N=622)Topical diclofenac vs oral diclofenacEnd of treatmentNS
Pain on movement, VAS (reduction from baseline)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboDays 1–14 and days 8–21 (end of treatment)Day 1–14: p=0.02
Day 8–21: p=0.005
Pain intensity, VAS (reduction from baseline)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboWeeks 1 2 and 3 (end of treatment)Week 1: p=0.03
Week 2: p=0.0002
Week 3: p=0.006
WOMAC pain (reduction from baseline)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboWeeks 2 and 3 (end of treatment)Week 2: p<0.0001
Week 3: p=0.0002
Pain on movement, VAS (reduction from baseline)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboDays 1–7;NS
Spontaneous pain, scale 0–3 (reduction from baseline)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboDays 1–7 and days 8–21NS
Pain relief (scale 0–4)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboDays 1–7 and days 8–21NS
WOMAC pain (reduction from baseline)1 RCT (Niethard et al. 2005) N=238Topical diclofenac vs placeboWeek 1NS
Pain at rest1 RCT (Trnavsky et al. 2004) N=50Topical ibuprofen vs placebo4 weeks (interim) and 8 weeks (end of treatment)Topical ibuprofen better than placebo
Pain on motion1 RCT (Trnavsky et al. 2004) N=50Topical ibuprofen vs placebo4 weeks (interim) and 8 weeks (end of treatment)Topical ibuprofen better than placebo
Overall pain1 RCT (Trnavsky et al. 2004) N=50Topical ibuprofen vs placebo4 weeks (interim) and 8 weeks (end of treatment)Topical ibuprofen better than placebo
Knee or hand or mixed sites
Pain reduction (from baseline)1 MA (Lin et al. 2004) Week 1: 7 RCTs (N=1000); week 2: 6 RCTs (N=893)Topical NSAIDs vs placeboWeek 1 and week 2Week 1: effect size 0.41, 95% CI 0.16 to 0.66, p≤0.05
Week 2: effect size 0.40, 95% CI 0.15 to 0.65, p≤0.05
Favours topical NSAIDs
Pain reduction (from baseline)1 MA (Lin et al. 2004) Week 3: 2 RCTs (N=442); week 4: 3 RCTs (N=558)Topical NSAIDs vs placeboWeek 3 and week 4NS

From: 7, Pharmacological management of osteoarthritis

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

All rights reserved. No part of this publication may be reproduced in any form (including photocopying or storing it in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright owner. Applications for the copyright owner’s written permission to reproduce any part of this publication should be addressed to the publisher.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.