Topical non-steroidal anti-inflammatory drug use for pediatric acute musculoskeletal pain: a scoping review.

IF 2
CJEM Pub Date : 2025-09-15 DOI:10.1007/s43678-025-00982-7
Domenic F Alaimo, Marah Al Masri, Mohamed Eltorki
{"title":"Topical non-steroidal anti-inflammatory drug use for pediatric acute musculoskeletal pain: a scoping review.","authors":"Domenic F Alaimo, Marah Al Masri, Mohamed Eltorki","doi":"10.1007/s43678-025-00982-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Topical non-steroidal anti-inflammatory drugs (NSAIDs) effectively treat acute musculoskeletal pain in adults, but evidence in children is limited. This scoping review aims to summarize current evidence for use in children and identify literature gaps to inform future research.</p><p><strong>Methods: </strong>We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews guidelines. Our electronic search included published studies across six databases, grey literature, and unpublished or ongoing trials. Studies involving children (< 18 years) with acute musculoskeletal pain treated with topical NSAIDs in Emergency Department (ED), urgent care, or ambulatory settings were included. We extracted data on study methodology, participant characteristics, clinical outcomes, adverse events, and rescue analgesia use. We performed critical appraisal using Joanna Briggs Institute tools.</p><p><strong>Results: </strong>Three studies met inclusion criteria: two randomized-controlled trials and one non-randomized trial, totaling 467 participants aged 6-18 years. Interventions included ketoprofen gel, methyl salicylate/1-menthol patch, and diclofenac epolamine patch for ankle sprains or minor soft tissue injuries. Treatment durations ranged from 30 minutes to 14 days. Studies varied in design, intervention protocols, outcome measures, and reporting quality. Common outcomes included pain reduction, rescue medication use, and adverse events. Overall, findings suggest topical NSAIDs may be effective and well tolerated for managing acute musculoskeletal pain in children. However, the available evidence has low credibility with high risk of bias and methodological heterogeneity. No studies compared topical with oral NSAIDs, and few assessed long-term safety, functional recovery, or participant-centered outcomes such as satisfaction or adherence.</p><p><strong>Conclusion: </strong>Topical NSAIDs may be a potential option for relief of acute musculoskeletal pain in children, although evidence is grossly limited. High-quality randomized-controlled trials are needed to evaluate the efficacy and safety of topical NSAIDs in children before recommendations for use in clinical practice can be made.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CJEM","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43678-025-00982-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Topical non-steroidal anti-inflammatory drugs (NSAIDs) effectively treat acute musculoskeletal pain in adults, but evidence in children is limited. This scoping review aims to summarize current evidence for use in children and identify literature gaps to inform future research.

Methods: We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews guidelines. Our electronic search included published studies across six databases, grey literature, and unpublished or ongoing trials. Studies involving children (< 18 years) with acute musculoskeletal pain treated with topical NSAIDs in Emergency Department (ED), urgent care, or ambulatory settings were included. We extracted data on study methodology, participant characteristics, clinical outcomes, adverse events, and rescue analgesia use. We performed critical appraisal using Joanna Briggs Institute tools.

Results: Three studies met inclusion criteria: two randomized-controlled trials and one non-randomized trial, totaling 467 participants aged 6-18 years. Interventions included ketoprofen gel, methyl salicylate/1-menthol patch, and diclofenac epolamine patch for ankle sprains or minor soft tissue injuries. Treatment durations ranged from 30 minutes to 14 days. Studies varied in design, intervention protocols, outcome measures, and reporting quality. Common outcomes included pain reduction, rescue medication use, and adverse events. Overall, findings suggest topical NSAIDs may be effective and well tolerated for managing acute musculoskeletal pain in children. However, the available evidence has low credibility with high risk of bias and methodological heterogeneity. No studies compared topical with oral NSAIDs, and few assessed long-term safety, functional recovery, or participant-centered outcomes such as satisfaction or adherence.

Conclusion: Topical NSAIDs may be a potential option for relief of acute musculoskeletal pain in children, although evidence is grossly limited. High-quality randomized-controlled trials are needed to evaluate the efficacy and safety of topical NSAIDs in children before recommendations for use in clinical practice can be made.

局部非甾体抗炎药用于小儿急性肌肉骨骼疼痛:范围审查。
目的:局部非甾体类抗炎药(NSAIDs)可有效治疗成人急性肌肉骨骼疼痛,但在儿童中的应用证据有限。本综述旨在总结目前用于儿童的证据,并确定文献空白,为未来的研究提供信息。方法:我们根据系统评价的首选报告项目和范围评价指南的扩展元分析进行了范围评价。我们的电子检索包括六个数据库中已发表的研究、灰色文献以及未发表或正在进行的试验。结果:3项研究符合纳入标准:2项随机对照试验和1项非随机试验,共467名6-18岁的受试者。干预措施包括酮洛芬凝胶、水杨酸甲酯/1-薄荷醇贴片和双氯芬酸依泊拉胺贴片治疗踝关节扭伤或轻微软组织损伤。治疗时间从30分钟到14天不等。研究在设计、干预方案、结果测量和报告质量方面各不相同。常见的结果包括疼痛减轻、抢救用药和不良事件。总的来说,研究结果表明局部使用非甾体抗炎药对于治疗儿童急性肌肉骨骼疼痛可能是有效且耐受性良好的。然而,现有的证据可信度较低,存在较高的偏倚风险和方法异质性。没有研究比较局部与口服非甾体抗炎药,很少评估长期安全性、功能恢复或以参与者为中心的结果,如满意度或依从性。结论:局部非甾体抗炎药可能是缓解儿童急性肌肉骨骼疼痛的潜在选择,尽管证据非常有限。在推荐用于临床实践之前,需要高质量的随机对照试验来评估儿童局部使用非甾体抗炎药的有效性和安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信