Pain Flashcards
What is a sprain
Occurs when one or more ligaments have been stretched twisted or torn, usually as a result of excessive force being applied to joints
Occurs in ankles knees wrist thumbs
Symptoms include pain around affected joint, inability to use the joint normally or bare any weight. Swelling and bruising may be present
What is a strain
Occurs when muscle fibres stretch or tear, usually the result of muscles being stretched beyond its limited or forced to contract to quickly
Legs (hamstring) back (lumbar)
Symtoms include swelling bruising redness - pain at rest and during use, muscle spasms weakness and loss of function of affected muscles
Back pain is
Self limiting (90%) gets better in 6 weeks
30/55 years
50-90% of pregnant women
Keep active and use analgesia
Refer if sciatica, bladder and bowel incontinence, pain above lumbar region and worsening and
more than 4 weeks
Elderly and below 12
Referred pain
Marked reduction in movement
Marked swelling bruising straight after injury
Unable to bear any weight and irregular shape
Advice to muscoskeletal injuries
P- protect R- rest I - ice wrapped in a blanket for 12-20 mins everyone 2-3 hours C- compression - snug not tight E - elevation to control swelling
In the first 48-72 hours avoid
H- heat
A- alcohol
R- running
M - massage
And oral NSAIDs
Headaches
Most likely - tension
Likely - migraine sinuses eye strain
Unlikely - cluster medication over use meningitis
Migraine symptoms and stages
Throbbing side on one side of the head (2/3 uni lateral) 1/15 men 1/5 women
Stages Premonitory 24h - mood changes appetite Aura 1H before - visual hallucinations Headache - 4-72 hours - unilateral - 90% experience nausea Resolution + recovery
Treatment for migraine
Migraleave - paracetamol codeine and bucclazirn
Imigran
Buccastem M (sumatriptan)
Keep a diary
Avoid irritating factors
Apply pressure cold compress
Sleep it off
Medication headaches
Overuse - analgesics may cause headache- wake up with the headaches- no other symptoms - stop abruptly - causes a rebound headache - refer to Gp
Nitrates - angina - throbbing bilateral- wears off
Combined oral contraceptive - refer to gp
Symptoms of cystitis
Common in women in 20s
Itching of the urethra
Urgency and frequency
Burning when urinating - dysuria
When to refer cystitis
Longer than 7 days Old or young Diabetics Men Haematouria Immuno Pregnant Vaginal discharge Fever
Treatment for cystitis
Analgesics - paracetamol
Potassium / sodium citrate
Mic contents on 1 sachet with a 200ml glass of water and drink- 1 sachet 3 times a day for 2 days
Large fluid intake
Empty bladder fully when at toilet do not resist urge
Avoid carbonated drinks coffee alcohol bubble bath bath oils vaginal deodorants
Sex - trigger- empty bladder before and after
Wipe from front to back
Avoid right underwear made from synthetic materials and right trousers
Symptoms of vaginal thrush
Pruritus which often is intense and burns
Vaginal discharge - clotted cream that is odourless
Dysuria - painful wee
Dyspareunia - painful sex
Treated without the GP but if repeated bouts the refer
Referral for thrush
Strong smelling discharge Diabetes Treatment failure 16-60 Pregnant Recurrent (more than twice in 6 months)
Treatment for vaginal thrush
Fluconazole capsule 150mg
Pessary - 50mg with applicator
2% clotrimazole external cream
10% clotrimazole internal cream
Avoid nylon underwear and tights
No vaginal deodorants or foam baths
Topical imidazoles can damage latex condoms
And diaphragms
Dysmenorrhea treatment symptoms and referral
Cramping rarely severe occurs short after period begins and lasts 3 days
Refer is heavy and unexplained bleeding
Signs of infection
Bleeding in post menopausal women
Women who are 30+ with worsening or new symptoms
Treatment- NSAID
ibuprofen - 1-2 tabs every 4 hours - max 6
Naproxen - 2 tablets on first day take another 6-8 hours later if needed - 3 max
Buscopan cranps- 2 tabs QDS
