Research Summary
Topical Diclofenac Eased Knee Arthritis Pain More Than Ketorolac Cream in a Small 2-Week Trial
Two anti-inflammatory creams both eased knee arthritis symptoms over two weeks, but standard diclofenac cream gave somewhat better pain relief than a ketorolac cream, a small double-blind trial found. The study was published online in October 2026 in Recent Advances in Inflammation & Allergy Drug Discovery.
What was studied
Topical NSAIDs (anti-inflammatory gels and creams rubbed on the skin) are a common choice for knee osteoarthritis because less of the drug reaches the rest of the body than with pills. But there are few head-to-head comparisons between different topical products.
Researchers in Iran randomly assigned 51 adults with X-ray-confirmed knee osteoarthritis (mild to moderate, Kellgren-Lawrence grade 1 to 3) to either ketorolac 2% cream or diclofenac 1% cream, applied three times a day for 14 days. Neither patients nor researchers knew who got which cream. Fifty people completed the study. Pain was measured on a visual analog scale and function with the WOMAC arthritis questionnaire.
Key findings
- Both groups had significant improvements in pain and function over the two weeks.
- The diclofenac group had significantly lower pain scores at day 7 and day 14.
- Function improved in both groups, with different patterns over time but no consistent advantage for either cream.
- Quality of life scores did not differ between groups.
- No serious side effects were reported.
What it means for people with knee pain
This trial adds support for topical NSAIDs as a reasonable, well-tolerated option for short-term knee arthritis pain, and it suggests the familiar diclofenac cream held up well against a ketorolac formulation. If you are considering a pain-relief cream, ask your doctor or pharmacist which one fits your health history, especially if you take other medicines.
Limitations
The study was small, ran for only two weeks, took place at one center in Iran, and had no placebo group, so it cannot show how much of the improvement was due to the creams themselves. The authors say larger, longer trials are needed to confirm the results.
Frequently asked questions
- What are topical NSAIDs?
- They are anti-inflammatory medicines, such as diclofenac, made as gels or creams that you rub on the skin over a painful joint. Less of the drug reaches the bloodstream than with NSAID pills.
- Which cream worked better for knee pain in this study?
- Diclofenac 1% cream produced lower pain scores than ketorolac 2% cream at both day 7 and day 14. Function improved in both groups without a consistent winner.
- Were there side effects?
- No serious side effects were seen with either cream during the two-week study. Because the trial was short and small, longer-term safety was not tested.
Sudden severe pain, swelling, or can't bear weight? Seek medical care promptly. In an emergency call 911.