Overall, topical nonsteroidal anti-inflammatory drugs (NSAIDs) are as effective as oral NSAIDs. Topical NSAIDs are also associated with fewer serious digestive side effects when compared with oral NSAIDs. 1b,c 2a,b

Topical NSAIDs are designed to act locally while minimising systemic exposure. 1a

Topical NSAIDs (gels, creams, sprays, or plasters) are applied to unbroken skin where there is a trigger of pain. Topical NSAIDs are known to penetrate the skin, enter tissues or joints, and reduce processes causing pain within the tissue. 2a,b 3a

Topical NSAIDs provide effective levels of pain relief and are considered as effective as oral NSAIDs in conditions such as sprains, strains and overuse injuries (result of repetitive micro-trauma to the tendons, bones, and joints e.g. tennis elbow, swimmer’s shoulder, runner’s knee and shin splints). The goal of treatment is to control the pain, promote healing, prevent complications, and restore normal use of the injured area. 1b 3b 4a 5a

When deciding which type of NSAID is best for your pain, consider this:

  1. Where is your pain? 2c
    Researchers say both oral and topical formulations are effective for pain, but topical NSAIDs may be better for localised pain near the surface of the skin. Oral NSAIDs may be better for allover pain or pain deep within your body.
  2. Length of treatment required? 1a-c 2a-c
    Oral NSAIDs should be used for the shortest term possible as long-term use can cause stomach ulcers and bleeding, liver and kidney damage, and an increased risk of heart attacks. Topical NSAIDs have a lower systemic absorption than oral NSAIDs and are generally considered a more suitable option for long-term use.
    Further, topical NSAIDs are an excellent choice especially for individuals who are at high risk of complications from oral medications.
  3. Consider the health risks? 2c
    Individuals with liver disease, high blood pressure, or heart disease should check with their doctors before taking NSAIDs in any form.

3 Benefits in one gel!

Norflex® Gel is a topical NSAID that you apply directly to your skin over the painful, inflamed muscle or joint area. It has the benefit of 3 actions to assist with pain as it is; 6,7

  • An anti-inflammatory action which assists with reducing the inflammation
  • An analgesic action which assists in relieving pain
  • A local anaesthetic action, this allows a slight numbing effect within the affected area to relieve pain

Speak to your healthcare provider or pharmacist to determine which treatment option is most suitable for you.

DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.

Name and business address of the holder of the certificate of registration: iNova Pharmaceuticals (Pty) Ltd,. Co. Reg. No. 1952/001640/07, 15e Riley Road, Bedfordview. Tel. No. 011 087 0000. For further information, speak to your healthcare professional. Further information is available on request from iNova Pharmaceuticals.


  1. Klinge SA and Sawyer GA. Effectiveness and safety of topical versus oral nonsteroidal anti-inflammatory drugs: a comprehensive review. Phys Sportsmed 2013;41(2):64-74.
  2. Harvard Medical School. NSAIDSs: topical vs. pills for pain. [online] January 2013 [Cited] 7 November 2018. Available from URL: 2/
  3. Topical non-steroidal anti-inflammatory drugs for acute musculoskeletal pain in adults. [online] 15 June 2015 [Cited] November 2022. Available from URL:
  4. Stop Sports Injuries. Overuse Injuries. [online] [Cited] November 2022. Available from URL:
  5. University of Rochester Medical Center. Overuse Injuries. [online] [Cited] November 2022. Available from URL:
  6. Difflam Gel. [online] 1 January 2008 [Cited] 2 May 2018. Available from URL: http://www.myvmc.comdrugsdifflam-gel/