Topical agents in the treatment of rheumatic disorders

Rheum Dis Clin North Am. 1999 Nov;25(4):899-918, viii. doi: 10.1016/s0889-857x(05)70109-5.


Topical drug delivery may be the optimal route for the treatment of localized musculoskeletal disorders because higher drug concentrations can be achieved at the sites of clinical significance. The rationale for the use of topical salicylates and other nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of soft-tissue rheumatic complaints and osteoarthritis is reviewed. Topical capsaicin offers another potentially beneficial therapy for the treatment of osteoarthritis of selected joints. Although there are extensive, uncontrolled experiences with DMSO that suggests its effectiveness in the treatment of musculoskeletal disorders, controlled trials yield conflicting results. The basis for the use of physical modalities such as phonophoresis and iontophoresis to improve topical drug efficacy is summarized.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Capsaicin / administration & dosage
  • Capsaicin / therapeutic use
  • Dimethyl Sulfoxide / administration & dosage
  • Dimethyl Sulfoxide / therapeutic use
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use
  • Iontophoresis / methods
  • Phonophoresis / methods
  • Rheumatic Diseases / drug therapy*


  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunosuppressive Agents
  • Capsaicin
  • Dimethyl Sulfoxide