Clinical practice guidelines for topical NSAIDs in the treatment of sports injury (2024 edition)_Chinese Journal of Evidence-Based Medicine

Authors：

 Chinese Society of Sports Medicine ,  Chinese Orthopaedic Association ,  Chinese Society of Physical Medicine and Rehabilitation , China Sport Science Society of Sports Medicine , China Medicine Education Association ,  Beijing Research Association for Chronic Diseases Control and Health Education

Corresponding author：

Chinese Society of Sports Medicine, Email: 18980601388@163.com; Chinese Orthopaedic Association, Email: Ligp@263.net; Chinese Society of Physical Medicine and Rehabilitation, Email: cshiyi@163.com; Beijing Research Association for Chronic Diseases Control and Health Education, Email: hxkfhhc@126.com

Keywords：

Topical NSAIDs; Sports injury; Clinical practice guideline

DOI：

10.7507/1672-2531.202402074

Video：

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Abstract Full text Figures/Tables Video References Cited by

Topical non-steroidal anti-inflammatory drugs (NSAIDs) are one of the commonly used drugs in the treatment of sports injury, but their standardized and rational use lacks evidence-based medical guidance. This guideline working group selected clinically important issues, fully collected the opinions of patients and clinical staff, and discussed them with the expert group. Based on the existing literature evidence, the "clinical practice guidelines for topical NSAIDs in the treatment of sports injury" was formulated following the methods and principles of international guidelines. In this guideline, 7 clinical concerns were finally selected, and a total of 22 recommendations were formed. Including the status, indications, contraindications, efficacy, combined application, use in special populations, adverse reactions, and countermeasures of topical NSAIDs in the treatment of sports injury. The purpose of this guideline is to provide evidence for orthopedics, sports medicine, rehabilitation medicine, sports science, and other practitioners in the treatment of sports injury, to promote the more standardized and rational use of topical NSAIDs.

Citation： Chinese Society of Sports Medicine, Chinese Orthopaedic Association, Chinese Society of Physical Medicine and Rehabilitation, China Sport Science Society of Sports Medicine, China Medicine Education Association, Beijing Research Association for Chronic Diseases Control and Health Education. Clinical practice guidelines for topical NSAIDs in the treatment of sports injury (2024 edition). Chinese Journal of Evidence-Based Medicine, 2024, 24(5): 497-509. doi: 10.7507/1672-2531.202402074 Copy

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1. 于永慧. “全民健身”与“健康中国”的理论阐释和政策思考. 北京体育大学学报, 2019, 42(2): 25-35.
2. 朱文辉, 陈世益. 外用非甾体抗炎药(NSAIDs)治疗肌肉骨骼系统疼痛的研究进展. 中国运动医学杂志, 2016, 35(5): 506-508.
3. Paoloni JA, Milne C, Orchard J, et al. Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use. Br J Sports Med, 2009, 43(11): 863-865.
4. 中华医学会运动医疗分会, 外用NSAIDs疼痛治疗中国专家委员会. 外用非甾体抗炎药治疗肌肉骨骼系统疼痛的中国专家共识. 中国医学前沿杂志(电子版), 2016, 8(7): 24-27.
5. 曲绵域, 于长隆. 实用运动医学. 北京: 北京大学医学出版社, 2003.
6. Rae K, Orchard J. The orchard sports injury classification system (OSICS) version 10. Clin J Sport Med, 2007, 17(3): 201-204.
7. 陈世益, 冯华. 现代骨科运动医学. 上海: 复旦大学出版社, 2020.
8. Timpka T, Jacobsson J, Bickenbach J, et al. What is a sports injury. Sports Med, 2014, 44(4): 423-428.
9. Mueller-Wohlfahrt HW, Haensel L, Mithoefer K, et al. Terminology and classification of muscle injuries in sport: the Munich consensus statement. Br J Sports Med, 2013, 47(6): 342-350.
10. Ross AG, Donaldson A, Poulos RG. Nationwide sports injury prevention strategies: a scoping review. Scand J Med Sci Sports, 2021, 31(2): 246-264.
11. van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries: a review of concepts. Sports Med, 1992, 14(2): 82-99.
12. 周谋望. 我国运动创伤康复的历史与展望. 中国康复医学杂志, 2019, 34(8): 885-887.
13. von Rosen P, Heijne A, Frohm A, et al. High injury burden in elite adolescent athletes: a 52-week prospective study. J Athl Train, 2018, 53(3): 262-270.
14. Moseid CH, Myklebust G, Fagerland MW, et al. The prevalence and severity of health problems in youth elite sports: a 6-month prospective cohort study of 320 athletes. Scand J Med Sci Sports, 2018, 28(4): 1412-1423.
15. Flood A, Waddington G, Thompson K, et al. Increased conditioned pain modulation in athletes. J Sports Sci, 2017, 35(11): 1066-1072.
16. 李志刚, 万滋衡, 梁莹. 社区人群业余体育活动中运动损伤的调查与分析. 中国医药导刊, 2010, 12(6): 1097-1098.
17. Christopher S, Tadlock BA, Veroneau BJ, et al. Epidemiological profile of pain and non-steroid anti-inflammatory drug use in collegiate athletes in the United States. BMC Musculoskelet Disord, 2020, 21(1): 561.
18. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet, 2019, 393(10182): 1745-1759.
19. 中华医学会骨科学分会关节外科学组, 中国医师协会骨科医师分会骨关节炎学组, 国家老年疾病临床医学研究中心(湘雅医院), 等. 中国骨关节炎诊疗指南(2021年版). 中华骨科杂志, 2021, 41(18): 1291-1314.
20. Cui A, Li H, Wang D, et al. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine, 2020, 26: 29-30.
21. Feucht CL, Patel DR. Analgesics and anti-inflammatory medications in sports: use and abuse. Pediatr Clin North Am, 2010, 57(3): 751-774.
22. Shah AK, Wei G, Lanman RC, et al. Percutaneous absorption of ketoprofen from different anatomical sites in man. Pharm Res, 1996, 13(1): 168-172.
23. Weiler JM. Medical modifiers of sports injury. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in sports soft-tissue injury. Clin Sports Med, 1992, 11(3): 625-644.
24. Derry S, Wiffen PJ, Kalso EA, et al. Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews. Cochrane Database Syst Rev, 2017, (5): CD008609.
25. Warner DC, Schnepf G, Barrett MS, et al. Prevalence, attitudes, and behaviors related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in student athletes. J Adolesc Health, 2002, 30(3): 150-153.
26. Holmes N, Cronholm PF, Duffy AJ, et al. Nonsteroidal anti-inflammatory drug use in collegiate football players. Clin J Sport Med, 2013, 23(4): 283-286.
27. McPherson ML, Cimino NM. Topical NSAID formulations. Pain Med, 2013, (14 Suppl 1): S35-S39.
28. Galer BS. All topical NSAIDs not created equal--understanding topical analgesic drug formulations. Pain, 2008, 139(1): 237-238.
29. Gorski T, Cadore EL, Pinto SS, et al. Use of NSAIDs in triathletes: prevalence, level of awareness and reasons for use. Br J Sports Med, 2011, 45(2): 85-90.
30. Choi E, Nahm FS, Han WK, et al. Topical agents: a thoughtful choice for multimodal analgesia. Korean J Anesthesiol, 2020, 73(5): 384-393.
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