A Cochrane review [Abstract] 1 included 15 studies with a total of 1 186 subjects, six placebo and one active controlled studies (560 and 137 participants) in acute pain, and seven placebo and two active controlled studies (489 and 90 participants) in chronic pain. All used topical salicylates. The evidence in acute conditions was not robust; using only better quality, valid studies, there was no difference between topical rubefacient and topical control, though overall, including lower quality studies, the NNT for clinical success compared with placebo was 3.2 (95% CI 2.4 to 4.9). In chronic conditions the NNT was 6.2 (95% CI 4.0 to 13) compared with topical placebo. This compares poorly with topical NSAIDs where substantial amounts of good quality evidence indicate that one in every three individuals treated will experience useful levels of pain relief Non-Steroidal Anti-Inflammatory Drugs (Nsaids) for Treating Lateral Elbow Pain. Adverse events and withdrawals occurred more often with salicylates than placebo, but most of the events occurred in only two studies.
Comment: The level of evidence is downgraded by study limitations and imprecise results.
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