Ankle sprain: the effects of non-steroidal anti-inflammatory drugs

Injury of the lateral ligament complex of the ankle joint occurs in about one in 10,000 people per day, accounting for a quarter of all sports injuries. We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of acute ankle sprains? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview). At this update, searching of electronic databases retrieved 158 studies. After deduplication and removal of conference abstracts, 97 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 48 studies and the further review of 49 full publications. Of the 49 full articles evaluated, one systematic review and four RCTs were added. We performed a GRADE evaluation for four PICO combinations. In this systematic overview, we categorised the efficacy for three interventions, based on information relating to the effectiveness and safety of oral NSAIDs versus placebo, oral versus topical NSAIDs, selective COX-2 inhibitors versus other NSAIDs, and topical NSAIDs versus placebo