THE EFFICACY OF ACETAMINOPHEN IN THE TREATMENT OF ANKLE SPRAINS: COMPARISON WITH DICLOFENAC SODIUM

Abstract

Objectives: Nonsteroid antiinflamatory drugs have been widely used and recommended for ankle sprains despite the fact that they are also known to lead significant adverse effects especially to the gastrointestinal system. The aim of this study is to assess the efficacy of acetaminophen in comparison with diclofenac sodium.

Patients and Methods: In this prospective, double blinded, parallel group study, one hundred patients suffering from first or second degree lateral ankle sprain within 48 hours of administration were comprised. Patients with bilateral injury, ipsilateral knee injury, trird degree sprain, previous sprain within 6 months and ankle pain less than 45 according to visuel analogue score (VAS) were excluded. In addition; history including gastrointestinal, renal or hepatic disease was the reason for exclusion. Prior to enrollment cases underwent physical examination. Patients rated pain on a 100 VAS, representing 0 no pain, 100 maximal pain. After enrollment patients were randomized (1:1); diclofenac sodium 150 mg/day or acetaminophen 1500 mg/day for 5 days. Patients tretaed by diclofenac sodium were called as group I and the others were group II. In addition; cases were prescribed other intervention modalities as RICE (rest, ice, compression, elevation) and crutches. Clinical assessments were carried out at baseline; on second, tenth days and sixth weeks (end of study). In each visit, VAS and adverse effects of medication were questioned.

Results: The mean VAS of the GI and GII at the first visit were 81, 82.3 respectively. These scores decreased to 20.7, 9.9, 4.6 and 11.9, 6.3, 3 at the second, tenth days and last examination. Similar reductions in pain were observed at the last visit (p> 0.05) in both groups. However; cases treated by acetaminophen showed accelerated decrease in VAS at day 2 and 10 in comparison with GI (p< 0.05). Regarding the ankle ROM there was similar increase in both groups (38.9°, 36.9°) respectively. There was no significant difference between groups with regard to ankle ROM at the last control (p> 0.05). The incidence of gastrointestinal adverse effects of GI was much more than GII. However there was no significant difference (p> 0.05).

Conclusion: It was concluded that diclofenac sodium and acetaminophen are effective and well tolarated short term treatment alternatives for acute ankle injuries.