Which medications in the drug class Nonsteroidal anti-inflammatory drugs are used in the treatment of Carpal Tunnel Syndrome?

Updated: Mar 30, 2020
  • Author: Nigel L Ashworth, MBChB, MSc, FRCPC; Chief Editor: Milton J Klein, DO, MBA  more...
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Answer

Nonsteroidal anti-inflammatory drugs

NSAIDs provide pain relief and reduction of inflammation. Reducing inflammation in the structures passing through the carpal tunnel decreases pressure and provides some relief to the compressed nerve.

Naproxen (Aleve, Anaprox, Naprelan, Naprosyn)

Naproxen is used for the relief of mild to moderate pain; it inhibits inflammatory reactions and pain by decreasing the activity of cyclo-oxygenase, which is responsible for prostaglandin synthesis.

Diclofenac (Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex)

Diclofenac is one of a series of phenylacetic acids that has demonstrated anti-inflammatory and analgesic properties in pharmacologic studies. It is believed to inhibit the enzyme cyclo-oxygenase, which is essential to the biosynthesis of prostaglandins. Diclofenac can cause hepatotoxicity; hence, liver enzymes should be monitored in the first eight weeks of treatment.

Diclofenac is rapidly absorbed; metabolism occurs in the liver by demethylation, deacetylation, and glucuronide conjugation. The delayed-release, enteric-coated form is diclofenac sodium; the immediate-release form is diclofenac potassium. Diclofenac has relatively low risk for bleeding GI ulcers.

Ibuprofen (Ibuprin, Motrin, Advil, NeoProfen, Caldolor)

Ibuprofen is the drug of choice (DOC) for patients with mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis. Ibuprofen inhibits cyclo-oxygenase-1 (COX-1) and COX-2 enzymes. This in turn results in decreased formation of prostaglandin precursors.

Indomethacin (Indocin)

Rapidly absorbed; metabolism occurs in liver by demethylation, deacetylation, and glucuronide conjugation; inhibits prostaglandin synthesis.


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