From the Guidelines
Yes, Voltaren (diclofenac) can be used for the management of prepatellar bursitis, particularly in the form of topical application, as it has been shown to be effective in reducing pain associated with osteoarthritis of the knee. Diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), is available as both oral medication and topical gel, and its topical formulation can be beneficial for localized conditions like prepatellar bursitis. According to a systematic review by Derry et al, as referenced in the 2021 Mayo Clinic Proceedings 1, topical diclofenac was found to be superior to placebo and equivalent to oral diclofenac in reducing pain associated with osteoarthritis of the knee.
For the management of prepatellar bursitis, applying Voltaren gel (1%) to the affected area 3-4 times daily, using approximately 2-4 grams per application, could be an effective approach. This method can help minimize systemic side effects associated with oral NSAIDs, such as gastrointestinal adverse events, which are markedly fewer with topical NSAIDs, although local adverse events may be more common 1.
Key considerations for the use of Voltaren in prepatellar bursitis management include:
- Limiting treatment duration to 7-14 days unless otherwise directed by a healthcare provider
- Using the medication alongside other conservative measures such as rest, ice application, compression, and elevation (RICE protocol)
- Exercising caution in patients with kidney problems, heart conditions, or a history of gastrointestinal bleeding, especially if considering oral NSAIDs, and consulting a healthcare provider before starting treatment. The mechanism of action of Voltaren, inhibiting prostaglandin synthesis to reduce inflammation and associated pain, supports its use in conditions characterized by inflammation, such as prepatellar bursitis.
From the Research
Management of Prepatellar Bursitis
The management of prepatellar bursitis depends on the type and cause of the condition.
- For acute traumatic/hemorrhagic bursitis, treatment is usually conservative with ice, elevation, rest, and analgesics 2.
- For chronic microtraumatic bursitis, treatment is also conservative, addressing the underlying cause, and analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) like Voltaren (Diclofenac) may be used 2, 3.
- There is no direct evidence in the provided studies that specifically mentions the use of Voltaren (Diclofenac) for the management of prepatellar bursitis, but NSAIDs are generally recommended for the treatment of bursitis 3, 4.
- In cases of septic bursitis, antibiotics are the primary treatment, and surgical intervention may be required in recalcitrant cases 2, 5.
- Surgical options such as endoscopic treatment may be considered for intractable bursitis, with satisfactory cosmetic and functional results 6.