Efficacy of transdermal anti-inflammatory patches for musculoskeletal pain: a systematic review and meta-analysis

<b>Aim:</b> To determine the efficacy of transdermal anti-inflammatory patches in the treatment of acute and chronic musculoskeletal pain. <b>Methods:</b> A comprehensive search of: Cochrane Central register of controlled trials, EMBASE, MEDLINE, CINAHL and PubMed, for studies using transdermal anti-inflammatory patches vs placebo for management of musculoskeletal pain, e.g. soft tissue injuries or tendonitis (last search January 2024). Cochrane Risk of Bias Tools v1 was used for quality assessment and GRADE determined certainty of evidence. Meta-analysis was performed. <b>Results:</b> Twenty-three randomized placebo-controlled trials (n = 4729) were included. There was low-certainty evidence that transdermal patches provided statistically and clinically significant pain relief on movement at long-term follow-up for chronic musculoskeletal pain (effect size -2-69 (95% CI: -4.14, -1.24) and at short-term follow-up which was non-clinically significant, (-1.24: 95% CI: -1.78, -0.69). <b>Conclusion:</b> Several types of transdermal anti-inflammatory patches may offer short-term and long-term pain relief for acute and chronic musculoskeletal conditions. However, the clinical significance of this effect for the long-term pain relief was based on low-certainty evidence of transdermal anti-inflammatory patches versus placebo; for short-term pain there was an overall non-clinically significant improvement. Performing a meta-analysis for all outcomes was not possible due to insufficiency in the evidence-base. <b>Protocol registration:</b>www.crd.york.ac.uk/prospero identifier is CRD42020185944. <b>Do medication Patches Really Help with Muscle &amp; Joint Pain? A Review of the evidence.</b> <b>What We Did:</b> We wanted to see if patches containing certain medicines that you stick on your skin can help with muscle and joint pain. We wanted to see if they did this in both in the short term and long term. <b>How We Did It:</b> We searched through medical databases to find research that compared these patches to fake treatments (placebos). We wanted to see if they work for muscle and joint pain. We checked the quality of these studies and combined their results when possible. <b>What We Found:</b> We found 23 studies that included a total of 4729 people. We found that these patches might help with long-term muscle and joint pain, but the evidence wasn't very strong. For short-term pain, the patches showed some improvement, but it wasn't enough to be considered important. <b>Conclusion:</b> Medication patches might help reduce muscle and joint pain in both the short and long term. However, the evidence for long-term pain relief isn't very strong, and the short-term benefits are not that large. This systematic review is the first to compare patches with placebo in musculoskeletal conditions. This systematic review assessed if transdermal patches delivering anti-inflammatory drugs are efficacious in relieving pain in acute and chronic musculoskeletal conditions. The results indicate low-certainty evidence that a variety of transdermal patches on several musculoskeletal conditions improved the pain on movement outcome at long term follow-up compared with placebo. There is low-certainty evidence of no benefit of pain on movement reduction in the medium-term of anti-inflammatory patches compared with placebo. A clinician may opt for anti-inflammatory transdermal patches to treat those with chronic musculoskeletal pain due to the reduction of adverse events associated with anti-inflammatory oral medication. This systematic review included a variety of transdermal patches used and of musculoskeletal conditions treated.