A topical nonsteroidal anti-inflammatory drug (NSAID) is a medication a patient can apply to the skin around an area of inflammation such as a swollen joint. The drug has a quick mechanism of action and limited systemic side effects because it is concentrated around the area of pain and inflammation. Some topical NSAIDs are available at pharmacies and drug stores without a prescription, while stronger medications require an examination and prescription from a doctor.

NSAIDs are a large family of drugs that work by blocking enzymes involved in pain signaling. They also reduce fevers and can have an anti-inflammatory effect when they are taken in high doses. These drugs also come with some potentially serious side effects, including liver disease and gastrointestinal hemorrhage. A patient who needs high doses or must take medication regularly can be at risk of severe side effects, and a topical NSAID may be a good choice for pain management because of the reduced risk of side effects.

These drugs come in gels, creams, and sprays. The patient should clean and dry the skin before applying the medication in the recommended amount. Skin readily absorbs compounds through the pores, and the drug will quickly seep through the skin and start working on the area immediately below. The patient should notice a reduction in pain with a topical NSAID, along with less swelling and heat around the site.

Since patients do not take the drug orally, the topical NSAID will not come into direct contact with the gastrointestinal tract, and the chance of complications related to stomach irritation is limited. The liver's workload is also much lower. Some of the drug will reach the liver eventually through the circulation, but not in the high concentrations seen with oral doses. The topical NSAID offers pain relief with lower side effects and can be safer for the patient than oral drugs, especially if he has an underlying health concern like a preexisting stomach ulcer.

If a topical NSAID appropriate for a patient is available, a doctor can recommend it and provide information about dosing. It is important to be careful with dosing and to pay attention to signs of allergic reactions like rashes, skin flushing, and bumps around the application site. Patients should not ingest topical drugs and must keep them out of the reach of children and pets, both of whom can have a severe reaction to some NSAIDs, especially if they consume medications only intended for topical use.