Pain and Analgesia

Question 1

What are the diagnostics for musculoskeletal pain?

Answer 1

Sprains, strains, repetitive strain
injuries (if they have pain in the
wrist and they are constantly
typing for example), broken bones, slipped discs.

Question 2

What is the treatment for musculoskeletal pain?

Answer 2

Paracetamol, ibuprofen,

aspirin, codeine, and dihydrocodeine.

Question 3

What non-pharmacological advice can be given for musculoskeletal pain?

Answer 3

Ensure that they are following the
dosing regimen closely and so are
taking it at regular intervals.

Question 4

When should musculoskeletal pain be referred?

Answer 4

If paracetamol and ibuprofen even in combination have not worked (there is no license for OTC sale of other NSAIDs)
Avoid the use of NSAIDs and morphine-derivatives in sufferers of asthma/COPD because they can cause respiratory depression.

Question 5

What are the diagnostics for a headache?

Answer 5

Tension, migraines, fever.

Question 6

What is the treatment for a headache?

Answer 6

Paracetamol, migraleve

(pink or yellow), aspirin.

Question 7

When should a headache be referred?

Answer 7

If under 12 when paracetamol
and/or aspirin have not worked (migraleve SPC dictates that Px must be at least 12 to receive codeine even in its low dose due to the unpredictable codeine to morphine conversion which could cause toxicity)
If over 12 and none of the aforementioned remedies have worked
If the patient is suffering from
eye pain as a result.

May refer patient to a
MECS-accredited optometrist who has an extra qualification.

Question 8

What non-pharmacological advice can be given for a headache?

Answer 8

Keep a food diary as there are very 
commonly trigger foods (cheese is
fairly normal).
Stay away from bright lights if
possible.
During an attack, it may help to lie down in a dark room.

Question 9

What is the treatment for cuts and bruises?

Answer 9

Paracetamol and ibuprofen
Potentially a barrier cream.
to ensure that the wound is
kept clean.

Question 10

What non-pharmacological advice can be given for cuts and bruises?

Answer 10

RICE
Rest.
Ice application.
Compression.
Elevation.

Question 11

When should cuts and bruises be referred?

Answer 11

If the patient is taking an
anti-coagulant meaning that they
don’t stop bleeding.