Traumeel vs. diclofenac for reducing pain and improving ankle mobility after acute ankle sprain: A multicentre, randomised, blinded, controlled and non‐inferiority trial

Summary Background Acute ankle sprains are common and activity limiting injuries, and topical diclofenac gel has proven efficacy in alleviating pain and restoring function. This trial aimed to compare a topical natural agent, Traumeel with topical diclofenac gel (1%) in the management of acute ankle sprain. Methods This prospective, multicentre, randomised, blinded, active‐control and non‐inferiority study involved 449 physically active adults sustaining unilateral grade 1 or 2 ankle sprain within the past 24 h. Participants were randomised to receive 2 g of Traumeel ointment (T‐O) ( n  = 152) or Traumeel gel (T‐G) ( n  = 150) or diclofenac gel (D‐G) ( n  = 147), administered topically to the ankle three times a day for 14 days, with 6‐weeks follow up. Results Day 7 median percentage reductions in Visual Analogue Scale pain score were 60.6%, 71.1% and 68.9% for the T‐O, T‐G and D‐G groups, respectively. Total pain relief was reported by 12 (8.5%), 7 (5.0%) and 8 (5.9%) participants in each group, respectively. Median improvements in Foot and Ankle Ability Measure Activities of Daily Living subscale score were 26.2, 26.2 and 25.0 points for T‐O, T‐G and D‐G groups, respectively. Mann–Whitney effect sizes and lower bound confidence intervals demonstrated non‐inferiority of Traumeel vs. diclofenac for reducing pain and functional improvement. At 6 weeks, participants reported total pain relief and normal functioning. Adverse events ( n  = 43) were reported by 31/447 participants (6.9%). Treatments were equally well tolerated. Conclusions T‐O and T‐G decreased pain and improved joint function to the same extent as D‐G in acute ankle sprain, and were well tolerated.