The effect of diclofenac sodium and paracetamol on active and passive range of ankle motion after sprains
The purpose of this study was to evaluate the effect of a NSAID, Diclofenac sodium, and an analgesic, Paracetamol in the reduction of pain and in the passive and active range of ankle motion of severe sprains. Ninety patients, 18 to 60 years old, with severe acute ankle sprain were randomized in two groups. Group A (45 patients) were given Diclofenac sodium tabs 75 mg 2 times a day for the first 10 days. The patients in group B (45 patients) received Paracetamol tabs 500 mg, 3 times daily for the pain. The patients had no significant differences concerning their baseline values. The restriction of active and passive ankle range of motion was significant decreased in both groups on the 10th day in comparison to the arrival day. There were no significant differences found between the two groups. The pain decreased in both groups on the third day and the tenth day. According to these results, both Diclofenac sodium and Paracetamol had the same effect on pain reduction, on passive and active range of ankle joint motion after sprains during the first 10 post traumatic days.
Andersson, S., Fredin, H., Lindberg, H. Ibuprofen and compression bandage in the treatment of ankle sprains. Acta Orthop Scand. 1983; 54:322-5. https://doi.org/10.3109/17453678308996578
Ashton-Miller, J.A., Ottaviani, R.A., Hutchinson, C. What best protects the inverted weightbearing ankle sprain against further inversion? J Sport Med. 1996; 24:800-809. https://doi.org/10.1177/036354659602400616
Bahamonde, L.A., Saavedra, H. Comparison of anti-inflamatory effects of diclofenac potassium versus piroxicam versus placebo in ankle sprain patients. J Int Med Res. 1990; 18:104-111. https://doi.org/10.1177/030006059001800205
Beynnon, B.D., Renström, P.A., Alosa, D.M. Ankle ligament injury risk factors: a prospective study of college athletes. J Orthop Res. 2001; 19:213-220. https://doi.org/10.1016/S0736-0266(00)90004-4
Boonstra, A.M., Schiphorst Preuper, H.R., Reneman, M. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008; 31:165-169. https://doi.org/10.1097/MRR.0b013e3282fc0f93
Boyce, S.H., Quigley, M.A., Campbell, S. Management of ankle sprains: a randomized controlled trial of the treatment of inversion injuries using an elastic support bandage or an Aircast ankle brace. Br J Sports Med. 2005; 39:91-96. https://doi.org/10.1136/bjsm.2003.009233
Colville, M.R., Amendola, N., Butters, M.A. Clinical Guideline on Ankle Injury. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1999.
Dahners, L.E., Gilbert, J.A., Lester, G.E. The effect of a nonsteroidal antiinflamatory drug on the healing of ligaments. Am J Sports Med. 1988; 16:641-646. https://doi.org/10.1177/036354658801600615
Dalton, J.D. Jr., Schweinle, J.E. Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Ann Emerg Med. 2006; 48:615-623. https://doi.org/10.1016/j.annemergmed.2006.05.015
Denegar, C.R., Hertel, J., Fonseca, J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther. 2002; 32:166-173. https://doi.org/10.2519/jospt.2002.32.4.166
Edwards, V., Wilson, A.A., Harwood, H.F.A. Multicentre comparison of Piroxicam and Indomethacin in acute soft tissue sports injuries. Journal of Internal Medicine. 1984; 12:46-50. https://doi.org/10.1177/030006058401200108
Fish, O.R., Wingate, L. Sources of goniometric error at the elbow. J Phys Ther. 1985; 65:1666-1670. https://doi.org/10.1093/ptj/65.11.1666
Fryer, G., Mudge, J., Mclaughlin, P. The effect of talocrural joint manipulation of range of motion at the ankle joint. J Manipulative Physiol Ther. 2002; 25:384-390. https://doi.org/10.1067/mmt.2002.126129
Garcia-Rodriguez, L.A., Cattaruzzi, C., Troncon, M.G., Agostinis, L. Risk of hospitalization for upper gastrointestinal tract bleeding associated with ketorolac, other nonsteroidal anti-inflammatory drugs, calcium antagonists, and other antihypertensive drugs. Arch Intern Med. 1998; 158:33-39. https://doi.org/10.1001/archinte.158.1.33
Gotzsche, P. Non-steroidal anti-inflamatory drugs. BMJ. 2000; 320:1058-1061. https://doi.org/10.1136/bmj.320.7241.1058
Green, T., Refshauge, K., Crosbie, J. A randomized controlled trial of a passive accessory joint mobilization on acute ankle inversion sprains. Phys Ther. 2001; 81:984-994.
Hippisley-Cox, J., Coupland, C. Risk of myocardial infraction in patients taking cyclo-oxygenage-2-inhibitors or conventional non steroidal anti-inflamatory drugs: population based nested case control analysis. BMJ. 2005; 330:1366. https://doi.org/10.1136/bmj.330.7504.1366
Ivins, D. Acute ankle sprain: an update. Am Fam Physician. 2006; 15(74):1714-1720.
Kayali, C., Agus, H., Surer, L. The efficacy of paracetamol in the treatment of ankle sprains in comparison with diclofenac sodium. Saudi Med J. 2007; 28:1836-1839.
Moseley, A., Adams, R. Measurement of passive ankle dorsiflexion: Procedure and reliability. J Aust Physiother. 1991; 37:175-181. https://doi.org/10.1016/S0004-9514(14)60540-7
Nadarajah, A., Abrahan, L., Lau, F.L. Efficacy and tolerability of celecoxib compared with diclofenac slow release in the treatment of acute ankle sprain in an Asian population. Sing Med J. 2006; 47:534-542.
Nield, S., Davis, K., Latimer, J., Maher, C. The effects of manipulation of range of motion at the ankle joint. Scand J Rehabilitation Med. 1993; 25:161-166.
Ogilvie Harris, D.J., Gilbart, M. Treatment modalities for soft tissue injuries of the ankle: a critical review. Clin J Sport Med. 1995; 5:175186. https://doi.org/10.1097/00042752-199507000-00008
Paolini, J.A., Orchard, J.W. The use of therapeutic medications for soft tissue injuries in sport medicine. Med J Aust. 2005; 3:384-388.
Pellow, J.E., Brantingham, J.W. The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and II ankle inversion sprains. J Manipulative Physiol Ther. 2001; 24:17-24. https://doi.org/10.1067/mmt.2001.112015
Safran, M.R., Zachazewski, J.E., Benedetti, R.S. Lateral ankle sprains: a comprehensive review part2: treatment and rehabilitation with an emphasis on the athlete. Med Sci Sports Exerc. 1999; 31: S438-447. https://doi.org/10.1097/00005768-199907001-00005
Schafer, A.I. Effects of nonsteroidal antiinflammatory drugs on platelet function and systemic hemostasis. J Clin Pharmacol. 1995; 35:209-219. https://doi.org/10.1002/j.1552-4604.1995.tb04050.x
Slatyer, M.A., Hensley, M.J., Lopert, R. A randomized controlled trial of piroxicam in the management of acute ankle sprain in Australian Regular Army recruits. The Kapooka Ankle Sprain Study. Am J Sports Med. 1997; 25:544-553. https://doi.org/10.1177/036354659702500419
Yepes, J.P., Ekman, E., Levy, S.D. Efficacy of celecoxib versus diclofenac in the treatment of pain associated with acute ankle sprain: a multicenter, doubleblind, randomized controlled trial. Ann Rheum Dis. 2002; 61 (Suppl1).
Wolfe, M.W., Uhl, T.L., Mattacola, C.G. Management of ankle sprains. Am Fam Physician. 2001; 63:93-104.
Copyright (c) 2011 Journal of Human Sport and Exercise
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.