Many people look to arthritis creams that can be rubbed on the joint.  These have been shown to have a favorable effect on symptoms of OA in some people.

Topical Ibuprofen May be Better

Some people can receive substantial benefit from arthritis creams.  A study published by researchers at the University of London compared oral vs. topical (cream) ibuprofen for their osteoarthritis knee pain.  Patients reported similar outcomes in terms of pain relief.  The number of adverse events with oral ibuprofen was higher than with the topical ibuprofen.  This paper concluded that “Advice to use oral or topical preparations has an equivalent effect on knee pain over one year, and there are more minor side effects with oral NSAIDs.”

[Underwood, M, Ashby, D, Cross, P, et al. Advice to use topical or oral ibuprofen for chronic knee pain in older people: randomised controlled trial and patient preference study. BMJ. 2008 Jan 19;336(7636):138-42.]

Be Aware of SalicylateToxicity

Some joint creams contain a drug called salicylate, a compound found in aspirin.  While Salicylates are widely used and relatively safe, some people using these creams excessively may deliver toxic doses of salicylate to their systems.  The Poison Control Centers report some 44,000 cases of salicylate poisoning each year.

In one study of arthritis creams, salicylic acid levels in the blood and urine rose significantly after several applications of arthritis cream over a four day period.

[Morra, P, Bartle, WR, Walker, SE, et al. Serum concentrations of salicylic acid following topically applied salicylate derivatives. Ann Pharmacother. 1996 Sep;30(9):935-40.]

The researchers noted that, “A considerable amount of salicylic acid may be absorbed through the skin after topical application of methyl salicylate products and this may increase with multiple applications. Caution is warranted in patients for whom systemic salicylate may be hazardous or problematic.”

Signs of salicylate toxicity might include spitting up blood, abnormally deep breathing, rapid breathing, shortness of breath, tinnitus (ringing in the ears), deafness, leathargy, or seizures.  Milder signs of salicylate sensitivity may also occur from topical arthritis creams.  It is not clear how frequently salicylate toxicity or sensitivity occurs in topical cream users.

Drug Interactions in OA

Potential for drug interactions in seniors with osteoarthritis