Lecture 5 - Self Care Flashcards
Bursitis
inflamed fluid filled sac in joint that becomes inflammed
hurts when moves
Tendonitis
inflammation of the tendon with motion
warm to touch, can be sudden
Tendon = bone - muscle
Sprains
injury to a ligament, pain is experienced during movement
Strain
Hyperextension of a muscle or tendon.
Pain at rest
Osteoarthritis (OA) or Degenerative Joint Disease (DJD
structure of joint wears out and the bones of the join are rubbing
Ligament connects
bone to bone
Myalgia Txm
Non drug: stretching, rest,heat
Drug: Topical, counter irritant, topical or oral analgesics
Tendonitis Txm
Non-drug: stretching, rest, ice, heat, immobilization
drug: topical counter-irritants, topical or oral analgesics
Bursitis Txm
Non-drug: joint rest, immobilization, ice
Drug: topical or oral analgesic
Sprain/Strain Txm:
Non-drug: RICE, stretching, protective wrap, assisted devices if needed
drug: topical counter-irritants, topical or oral analgesics
Who 3 Ladder step
- mild
- moderate
- severe
Common topical agents
Methyl salicylate Camphor Menthol Capsaicin Lido cream
Common topical info
most useful in pain states that have predominate peripheral cause
may not be sufficient to produce total pain relief used alone
Counterirritant
Methyl salicylate
Camphor
Menthol
Counterirritant info
“temp relief of minor aches and sprains of muscles/joints”
recommended as adjunct to mscleskeletal injuries and disorders
produces mild, local, inflammatory reaction. These sensations distract from the deep seated pain
decrease transmission of pain
Analgesic and Anesthetics products
capsaicin
Lidocaine
block pain
Counterirritant Efficacy
mixed evidence, not alot
Counterirritant Dosing
can be used prn or scheduled multiple doses per day
Counterirritant Potential adverse effects
- caution if pt develops irritation, rash, burning,stining, swelling, or infection
- external analgesics avoided in children < 2, very cautious in < 18 and use least amount of time possible
Counterirritant counseling points
Apply only to intact skin
Light bandage over application is ok
Avoid heating pads or other devices, inc absorption
Methyl salicylate: caution ppl w/ severe asthma, sensitive to aspirin, or nasal polyps
Capsaicin info
Helpful in nociceptive and neuropathic pain
Capsaicin dosing
must be appleid 2-4 times a day, takes a few days to work
Do not apply PRN
Capsaicin Counseling points
When applied, feeling of warmth
avoid contact with mucosa, wear gloves
dont use with heating pad
Lidocaine MOA
blocks sodium channel to help with pain
Lidocaine most apporiate
well localized neuropathic pain
Lidocaine can be used as…
monotherapy or in combo with TCA, SNRI, Gabapentin
No adjustment is necessary when renal dysfunction
Lidocaine comes in….
3% cream
5% ointment
5% = Rx Patch 4% = OTC patch
Lidocaine patch Counseling
can be cut
remove after 12hrs then keep off for 12hrs
max 3 at one time
apply intact skin only
Glucosamine, Chondroitin, Methylsulfonylmethane are used primarily in…
OA and joint health
they are dietary supplements
Glu + Cho = building materials for cartilage
MSN = anti-inflammatory
THC has to be below what % in CBD
0.3%
Pt should be referred to health care provider if…
Visually deformed, abnormal movement, weakness in limb
Pain > 6 on 1-10
Inc in intensity of pain
Last > 2 weeks
Pain continues < 7 days
< 2 yrs old
N,V,F or other sx of infection
Pelvic or abdominal pain
RICE treatment
Rest
Ice
Compression
Elevation - above heart
for acute treatment
Cold counseling points
Dont use on lacerations
Dont use for > 20 min
Dont use in pts with impaired sensation or circulation
When to use cold
Within 1st 48/72hrs..causes vasoconstriction
Don’t use if already swollen
When to use heat
after 72hrs, causing vasodilation
Dry heat
little to no moisture
ie Heating pad, hot water bottle, instant heat packs
Moist heat
has moisture
ie moist heatpack, thermophore
TENS therapy CI
Cant use in Pacemaker patients Cant use pregnant don't use on Carotid Sinus Don't use on neck Dont use in pts with impaired sensory cautiously in pts that have other electronic device
Active compression
provide compression during both contraction and rest
Passive compression
only when muscle is contracted
Compression products used for…
injury
prevention of DVT
Which stockings do you wanna stay away from?
those that are 8-15 mmHg
TED stockings used for…
Patients that are laying in bed
TEDS for BEDS
graduated compression stockings are used for patients that aren’t confined to the bed
Compression ranges for graduated compression stockings
15-20mmHG - 50-60mmHG
Anti-embolism stockings should be in which compression ranges?
18-8mmHG or 20-10mmHG
