This information is for people who have osteoarthritis. It tells you about creams and gels containing NSAIDs, a treatment used for osteoarthritis. It is based on the best and most up-to-date research.
Do they work?
Yes. There is good evidence that NSAID creams or gels rubbed into the joint can relieve the pain of osteoarthritis.
What are they?
Painkilling creams or gels for osteoarthritis usually contain nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen is a common NSAID.
You can also take NSAIDs as tablets.
You can buy some painkilling creams or gels that contain NSAIDs without a prescription from a pharmacy. These contain the NSAIDs ibuprofen or diclofenac. And doctors can prescribe a range of creams and gels that contain higher doses of NSAIDs. These could contain ibuprofen, piroxicam, ketoprofen, felbinac, or diclofenac.
The table lists some common brand names of painkilling creams and gels. You can get piroxicam gel from your doctor as a non-branded (generic) version.
|Brand name of cream or gel||NSAID it contains||Needs a prescription?|
|Nurofen Gel Maximum Strength||ibuprofen||No|
|Voltarol Emulgel P||diclofenac||No|
Creams or gels may be more useful for osteoarthritis in your hand or knee than in your hip, where the joint is deeper.
How can they help?
Regularly using creams or gels containing an NSAID can reduce knee pain.    Studies have looked at creams or gels containing drugs like ibuprofen and diclofenac. People used them for a few weeks. We don't know how well they work in the long term.
Several studies show that diclofenac gel may help your knees feel less stiff and make it easier to stand up, walk and climb stairs.    The cream is usually applied four times a day, and works within an hour.
We don't know whether creams and gels work better than taking NSAID tablets. But we do know they are less likely to cause side effects such as stomach upsets.    This is because not as much of the drug gets into the bloodstream when it's put on the skin.
How do they work?
NSAIDs reduce pain and inflammation. The NSAIDs in creams and gels are absorbed through the skin.
Can they be harmful?
Creams or gels only affect the area that you rub them into. So they are less likely to have side effects than painkilling tablets, which affect the whole body.
There have been reports of liver problems, some serious, in people taking the NSAID diclofenac.  Your doctor may suggest regular tests to check how well your liver is working.
NSAID gels may cause itchiness and a rash. 
Gels containing ketoprofen can make your skin more sensitive to sunlight.  Avoid direct sunlight and sunbeds if you’re using this treatment, and be careful for the two weeks after you stop using it. If you get a skin reaction, see your doctor.