Oral versus topical Ibuprofen for chronic knee pain: a prospective randomized pilot study

Pain Physician. 2010 Sep-Oct;13(5):457-67.


Background: Topical ibuprofen provides an alternative treatment to oral ibuprofen for the treatment of chronic knee pain.

Objective: To compare the efficacy of topical versus oral ibuprofen in chronic knee pain treatment.

Study design: Prospective, randomized, unblinded pilot study.

Setting: A private pain management practice.

Methods: Twenty patients received either ibuprofen tablets 3 times daily (2400 mg total) or 4% topical gel 4 times daily (320 mg total) for 2 weeks. Subjects completed the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, the Medical Outcomes Study 12-Item Short Form (SF-12v2) Health Survey, and a satisfaction questionnaire.

Results: Comparison of WOMAC and SF-12v2 mean changes from baseline showed no differences between groups. Patient satisfaction and study treatment convenience were rated equivalently between groups. Within the topical group, significant improvements (P < 0.05) were experienced in the mean differences of WOMAC Pain scores from baseline to 2 weeks (-82.6, -158.3 to -6.8), WOMAC Stiffness scores from baseline to one week (-25.3, -50.0 to -0.6) and baseline to 2 weeks (-47.8, -95.7 to 0.1), WOMAC Physical Function scores from baseline to one week (-175.9, -348.6 to -3.2) and baseline to 2 weeks (-312.1, -580.5 to -43.7), and patient satisfaction scores from baseline to one week and baseline to 2 weeks. Within the oral group, significant improvements (P < 0.05) were experienced in mean differences of WOMAC Physical Function from baseline to one week (-342.6, -638.1 to -47.1) and baseline to 2 weeks (-323.2, -637.1 to -9.2).

Limitations: As this was a preliminary investigation, the sample size of 20 subjects is a limitation in this study.

Conclusion: Treatment of chronic knee pain with topical ibuprofen provided comparable clinical efficacy and patient satisfaction as oral ibuprofen in this pilot study.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Chronic Disease
  • Female
  • Humans
  • Ibuprofen / administration & dosage*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / complications
  • Osteoarthritis, Knee / drug therapy*
  • Pain / drug therapy*
  • Pain / etiology
  • Pilot Projects


  • Anti-Inflammatory Agents, Non-Steroidal
  • Ibuprofen