Abstract

According to modern ideas, pain is a multidisciplinary problem with serious medical and socio-economic importance. The most common pain occurs in various structures of the musculoskeletal system. It is noted that the universal mechanism of acute and chronic pain is inflammation, which requires therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Data on the effectiveness and good tolerability of local NSAIDs are presented. The latest recommendations of the international Committee ESCEO 2019 on the management of patients with osteoarthritis (OA), which confirms the effectiveness and safety of local forms of NSAIDs, in connection with which, ESCEO recommends their use in elderly patients, in patients with comorbid conditions and at high risk of adverse reactions. It is also envisaged to use these drugs for the treatment of OA before the appointment of systemic NSAIDs. The results of randomized clinical trials (RCTS) and meta-analyses confirming clinical efficacy and safety in the treatment of acute and chronic pain by one of the representatives of local NSAIDs-diclofenac sodium gel are presented. Diclofenac sodium gel has been shown to be more effective than placebo in the treatment of acute and chronic pain. Good tolerability of the drug was observed in patients in different age groups, including patients older than 65 years, and in patients with comorbid conditions. The results obtained indicate the effectiveness and good tolerability of diclofenac sodium gel, including long-term, and allow the drug to be widely used as symptomatic therapy for the treatment of acute and chronic pain, including in elderly patients and patients with comorbid conditions.

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