Ibuprofen vs diclofenac in the management of acute musculoskeletal injury
Date First Published:
July 14, 2010
Last Updated:
July 18, 2010
Report by:
Alexia Williams, ST1 (Whiston Hospital)
Three-Part Question:
In [adults with acute musculoskeletal injury] is [diclofenac superior to ibuprofen] in [reducing pain]?
Clinical Scenario:
A 24 year old man presents to the ED complaining of having injured his knee earlier that evening in a football match. He is in a significant amount of pain so you prescribe him diclofenac. A medical student asks why you prescribed diclofenac rather than ibuprofen, given its higher risk of gastro-intestinal complications. You inform the student that diclofenac is a better analgesic than ibuprofen but wonder if there is any evidence to support this.
Search Strategy:
Medline 1996 to June Week 5 2010 via the OVID interface
[exp musculoskeletal system OR exp musculoskeletal diseases OR exp leg injuries OR exp wounds and injuries OR exp arm injuries] AND [ibuprofen ti.ab.sh AND diclofenac ti.ab.sh]
LIMIT to human AND English
[exp musculoskeletal system OR exp musculoskeletal diseases OR exp leg injuries OR exp wounds and injuries OR exp arm injuries] AND [ibuprofen ti.ab.sh AND diclofenac ti.ab.sh]
LIMIT to human AND English
Outcome:
120 papers were identified, of which none were relevant.
Author Commentary:
There is no literature reviewing the efficacy of diclofenac compared to ibuprofen.
Bottom Line:
While NSAIDs are commonly used drugs in the ED, there is no literature to support the notion that diclofenac has superior analgesic qualities to ibuprofen. Local hospital/pharmacy guidelines should be followed pending research.