Evidence map›Paper›PMID 40952589›Full record

ArticleCJEM2026

Topical non-steroidal anti-inflammatory drug use for pediatric acute musculoskeletal pain: a scoping review.

Domenic F Alaimo, Marah Al Masri, Mohamed Eltorki

Abstract readScoping Review
PubMed Publisher
In one paragraph

Article in CJEM, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Domenic F AlaimoSchulich School of Medicine and Dentistry, Western University, London, ON, Canada. dalaimo2027@meds.uwo.ca.ORCID 0009-0005-7849-8720
Marah Al MasriFaculty of Science, McMaster University, Hamilton, ON, Canada.
Mohamed EltorkiDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.ORCID 0000-0001-6978-0015

Funding

Canadian Institute of Health Research
6 · The paper itself

Abstract

objectiveTopical non-steroidal anti-inflammatory drugs (NSAIDs) effectively treat acute musculoskeletal pain in adults, but evidence in children is limited. This scoping review aims to summarize current evidence for use in children and identify literature gaps to inform future research.

methodsWe conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews guidelines. Our electronic search included published studies across six databases, grey literature, and unpublished or ongoing trials. Studies involving children (< 18 years) with acute musculoskeletal pain treated with topical NSAIDs in Emergency Department (ED), urgent care, or ambulatory settings were included. We extracted data on study methodology, participant characteristics, clinical outcomes, adverse events, and rescue analgesia use. We performed critical appraisal using Joanna Briggs Institute tools.

resultsThree studies met inclusion criteria: two randomized-controlled trials and one non-randomized trial, totaling 467 participants aged 6-18 years. Interventions included ketoprofen gel, methyl salicylate/1-menthol patch, and diclofenac epolamine patch for ankle sprains or minor soft tissue injuries. Treatment durations ranged from 30 minutes to 14 days. Studies varied in design, intervention protocols, outcome measures, and reporting quality. Common outcomes included pain reduction, rescue medication use, and adverse events. Overall, findings suggest topical NSAIDs may be effective and well tolerated for managing acute musculoskeletal pain in children. However, the available evidence has low credibility with high risk of bias and methodological heterogeneity. No studies compared topical with oral NSAIDs, and few assessed long-term safety, functional recovery, or participant-centered outcomes such as satisfaction or adherence.

conclusionTopical NSAIDs may be a potential option for relief of acute musculoskeletal pain in children, although evidence is grossly limited. High-quality randomized-controlled trials are needed to evaluate the efficacy and safety of topical NSAIDs in children before recommendations for use in clinical practice can be made.

Indexed as

Acute PainAnti-Inflammatory Agents, Non-SteroidalMusculoskeletal PainAdministration, TopicalAdolescentChildHumansPain MeasurementAnti-Inflammatory Agents, Non-SteroidalEmergency departmentMusculoskeletal painNon-steroidal anti-inflammatory drugsPediatric

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.