Materials and methods :~Study design It is a randomized, prospective, double blind, controlled, multicentric trial.~Study setting and selection of participants :~The trial is conducted in three community teaching hospitals :~Emergency department, fattouma bourgiba university hospital, monastir, tunisia.~Emergency department, sahloul university hospital, sousse, tunisia.~Emergency department, farhat hached university hospital, sousse, tunisia.~The study includes patients aged 18 to 60 years who presented to the ED with acute soft-tissues limb trauma pain occurring within 24 hours before presentation, with a visual numeric scale (VNS) of 5 or more on a standard 11 point (0-10) and who required a prescription for home use analgesic treatment upon discharge. An informed consent is necessary. Pain was considered traumatic if it is reported as appearing immediately after the trauma.~Protocol :~After medical evaluation, every patient who meet the inclusion criteria, will receive randomly either Piroxicam gel or Soulagel tubes as detailed above according to the predetermined randomization.~None of the treating physician or nurses are aware about the medication received.~Adhesive and/or immobilizing casts, bandages, splints, and treatment by rest, ice, compression, or elevation were prohibited after randomization.~Patients could not take additional medications such as oral NSAIDs, opioids, muscle relaxants, or supplemental topical therapies.~Patients were phonelly contacted in order to ensure treatment adherence and evaluate VAS once a day until the end of the treatment. After the end of the treatment, patients' satisfaction with the treatment was noted and quoted as not satisfied, satisfied, and very satisfied.~Need for rescue analgesic treatment was noted as well as the dose and duration. All patients were encouraged to report all adverse events during the treatment period. S~All data recorded on data collection sheets, including sex, demographics, medical history, and vital signs, were entered into SPSS (version 20.0 ; IBM corps) by the research manager.~Patients's informed consent is obtained. The ethic commitee of our institution approved the study.
Acute soft tissues injuries are a common complaint for emergency department (ED) visit. RICE and Topical non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used to reduce pain and inflammation. Herbal therapy is commonly used to treat pain but few studies assessed its efficacy and tolerability.