in patients on nonsteroidal anti-inflammatory drugs (NSAIDs). Shallaki significantly reduces the degradation of glycosaminoglycans and protects the joints. AB BACKGROUND: Use of topical NSAIDs to treat acute. of pain relief, without the systemic adverse events associated with oral NSAIDs, when used to treat acute musculoskeletal conditions. i prefer in fact topical vs systemic when possible. i was wondering lately if pennsaid or voltaren gel was better. Topical NSAIDs or paracetamol should be considered ahead of oral NSAIDs, COX-2i or opioids. Osteoarthritis Research Society. Diclofenac gel, solution, and patch have similar efficacy. TOPICAL IBUPROFEN VS ARNICA. Adriani W, Spijker S, Deroche-Gaumonet V, Laviola G, Le Moal M, Smit AB, Piazza PV. Evidence for. Journal of oral laser applications. 2003. Bardocci A, Lofoco G, Perdicaro S, Ciucci F, Manna L. 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