A total of 120 patients with moderate to severe pain due to localized rheumatic or traumatic conditions participated in a double-blind, randomized trial. Patients were randomly allocated to receive ultrasonic sessions three times weekly for 4 weeks, using either diclofenac in a gel base (Voltaren Emulgel) or regular gel as a coupling medium. A statistically significant (p < 0.01) improvement was achieved in both treatment groups in most of the evaluation criteria by the end of the first week. Treatment was prematurely discontinued due to complete cure in 60% of patients using Voltaren Emulgel compared with only 15% of those using regular gel (p < 0.01). Physician's assessment of complete relief of pain was also statistically significant (p < 0.01) in favour of Voltaren Emulgel throughout the trial period and the physician's overall assessment of therapeutic efficacy revealed that a satisfactory result was achieved in 86% of Voltaren Emulgel-treated patients compared with 76% of patients receiving regular gel (p < 0.05). Tolerability was good or excellent in over 95% of patients in both treatment groups. The results of the study strongly suggest that the use of Voltaren Emulgel as a coupling medium during ultrasonic therapy is a preferable, effective alternative to the currently used regular gel.

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