Is topical ibuprofen gel as good as oral ibuprofen for arthritis?
For knee and hand osteoarthritis, NICE now recommends topical NSAID gels as first-line — they work almost as well as oral NSAIDs for pain but with a fraction of the stomach, kidney and cardiovascular risk. Oral NSAIDs remain useful for deep joints (hip, spine) or widespread inflammation but should be used at the lowest effective dose for the shortest possible time.
Last updated 2026-07-04. This is general information, not a substitute for personalised medical advice.
Frequently asked questions
When would you pick Topical NSAID gel?
Hand or knee OA; localised joint pain; older adults; anyone on multiple medications.
When would you pick Oral NSAID (tablets)?
Hip/spine OA; inflammatory arthritis flares; short bursts under GP supervision.
What should I be careful about?
Topical NSAIDs still carry a small systemic absorption risk — avoid on broken skin and follow the pack instructions.