Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: a multicentre, randomised, blinded, controlled and non-inferiority trial

Int J Clin Pract. 2013 Oct;67(10):979-89. doi: 10.1111/ijcp.12219. Epub 2013 Jul 25.

Abstract

Background: Acute ankle sprains are common and activity limiting injuries, and topical diclofenac gel has proven efficacy in alleviating pain and restoring function. This trial aimed to compare a topical natural agent, Traumeel with topical diclofenac gel (1%) in the management of acute ankle sprain.

Methods: This prospective, multicentre, randomised, blinded, active-control and non-inferiority study involved 449 physically active adults sustaining unilateral grade 1 or 2 ankle sprain within the past 24 h. Participants were randomised to receive 2 g of Traumeel ointment (T-O) (n = 152) or Traumeel gel (T-G) (n = 150) or diclofenac gel (D-G) (n = 147), administered topically to the ankle three times a day for 14 days, with 6-weeks follow up.

Results: Day 7 median percentage reductions in Visual Analogue Scale pain score were 60.6%, 71.1% and 68.9% for the T-O, T-G and D-G groups, respectively. Total pain relief was reported by 12 (8.5%), 7 (5.0%) and 8 (5.9%) participants in each group, respectively. Median improvements in Foot and Ankle Ability Measure Activities of Daily Living subscale score were 26.2, 26.2 and 25.0 points for T-O, T-G and D-G groups, respectively. Mann-Whitney effect sizes and lower bound confidence intervals demonstrated non-inferiority of Traumeel vs. diclofenac for reducing pain and functional improvement. At 6 weeks, participants reported total pain relief and normal functioning. Adverse events (n = 43) were reported by 31/447 participants (6.9%). Treatments were equally well tolerated.

Conclusions: T-O and T-G decreased pain and improved joint function to the same extent as D-G in acute ankle sprain, and were well tolerated.

Trial registration: ClinicalTrials.gov NCT01066520.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Analgesics / administration & dosage*
  • Analgesics / adverse effects
  • Ankle Injuries / drug therapy*
  • Ankle Injuries / physiopathology
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Arthralgia / prevention & control*
  • Diclofenac / administration & dosage*
  • Diclofenac / adverse effects
  • Double-Blind Method
  • Female
  • Gels
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Minerals / administration & dosage*
  • Minerals / adverse effects
  • Ointments
  • Pain Measurement
  • Plant Extracts / administration & dosage*
  • Plant Extracts / adverse effects
  • Prospective Studies
  • Range of Motion, Articular / drug effects
  • Treatment Outcome
  • Young Adult

Substances

  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Gels
  • Minerals
  • Ointments
  • Plant Extracts
  • Traumeel S
  • Diclofenac

Associated data

  • ClinicalTrials.gov/NCT01066520