Pharmacy Unscripted - Holistic management of Pain

Question 1

What does treating pain in a holistic way mean?

Answer 1

rather than just recommending analgesics, we should be treating pain in a more holistic way, taking into account both mental and social factors rather than just managing the symptoms.

Question 2

What is important to reassure to patients with back pain?

Answer 2

Reassure patients that their back pain will get better; people who manage to stay positive tend to recover quicker.

Question 3

What else can you encourage someone to do who has lower backpain?

Answer 3

Could also encourage customers to stay active, as resting for long periods can make the pain worse.

Question 4

What may lower back pain be managed by?

Answer 4

Pain may be managed with anti-inflammatory painkillers such as ibuprofen and by using hot or cold compression packs.

Question 5

What complementary therapies can patients consider for lower back pain?

Answer 5

massage, physiotherapy, osteopathy or chiropractic therapy

Question 6

Which side of the head does tension headaches affect?

Answer 6

Tension type headaches affect both sides of the head.

Question 7

What is tension type headaches described as?

Answer 7

The pain is mild to moderate and described as pressing or tightening. It is not aggravated by daily activities.

Question 8

Which side of head does migraine affect?

Answer 8

Migraine can affect one or both sides of the head.

Question 9

What is migraine headaches described as?

Answer 9

The pain is described as moderate or severe and pulsating. Daily activities often aggravate the pain.

Question 10

What can migraine (headaches) be accompanied by?

Answer 10

Migraine can be accompanied by sensitivity to light and/or sound and aura.

Question 11

Who should migraines be diagnosed by?

Answer 11

Migraine should be diagnosed by a GP

Question 12

What painkillers can be taken for migraine headaches?

Answer 12

Painkillers, such as aspirin, paracetamol and ibuprofen, can be taken to manage pain

Question 13

When is it best to take painkillers for migraines and what formulations is preferred?

Answer 13

are best taken as soon as possible after onset and soluble preparations may work quicker.

Question 14

Who can take take sumatriptan?

Answer 14

Suitable customers, who have been previously diagnosed with migraine, can take sumatriptan.

Question 15

What ingredients can help with nausea associated with migraine?

Answer 15

Preparations containing buclizine or prochlorperazine can help with nausea associated with migraine.

Question 16

What holistic advice can be given to patients suffering from migraine headaches?

Answer 16

• Encourage customers to keep a headache diary to identify triggers such as alcohol, dehydration, skipping meals or lack of sleep; once identified, try to avoid them7
• Eat a healthy balanced diet – up to half of migraine sufferers could be magnesium deficient.8 Green leafy vegetables, nuts, seeds and wholegrains are good sources of magnesium and supplements are available to help maintain normal levels
• Keep hydrated – drink enough water during the day as dehydration can cause headaches
• Exercise regularly – studies have shown that exercise reduces the frequency and severity of headaches8
• Using a cold compress can help reduce headache pain

Question 17

Does pain in several joints require referral?

Answer 17

Yes, pain in several joints should be referred to the GP.

Question 18

If the joint pain is caused by an injury such as a sprain, strain or tendonitis from over use then customers can be advised to use what?

Answer 18

Can be advised to use PRICE.

Question 19

What is PRICE when giving advice on joint pain?

Answer 19

Protect – wear a brace or support to protect the joint from further damage

Rest – avoid exercise and reduce the daily routine

Ice – apply an ice pack to the affected area for 15-20 minutes every two to three hours

Compression – use elastic compression bandages during the day to limit swelling

Elevation – keep the injured body part raised above the level of the heart whenever possible. This may also help to reduce swelling.

Question 20

Joint pain that isn’t caused by injury is often due to what?

Answer 20

Osteoarthritis

Question 21

What are the main symptoms of Osteoarthritis?

Answer 21

joint pain and stiffness, which cause problems moving the joint.

Question 22

What advice can be given to patients that have mild symptoms of osteoarthritis?

Answer 22

• Regular exercise – swimming and cycling put less strain on the knees and build the muscles helping to support the joint
• Losing weight if they’re overweight
• Wearing suitable footwear
• Using special devices to reduce the strain on the joints during everyday activities e.g. orthotics or braces.

Question 23

What are the next steps if symptoms of osteoarthritis are more severe?

Answer 23

Additional treatments such as painkillers may be required. You could advise customers to start with either paracetamol or a topical non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or diclofenac. If this does not provide sufficient pain management then they can swap to an oral NSAID.10 TENS machines can also be useful in managing the pain associated with osteoarthritis.

Question 24

Who can use glucosamine?

Answer 24

For mild symptoms of osteoarthritis of the knee, that has previously been diagnosed by a doctor, there is a glucosamine product that has a pharmacy medicine licence.

Question 25

Where is glucosamine also found?

Answer 25

Glucosamine is also found in some food supplements,

Question 26

Has there been approved claims for glucosamine to support joint health?

Answer 26

No, there are no approved claims to support joint health.

Question 27

Which vitamins may patients choose for bones?

Answer 27

vitamins C, D and K, calcium, magnesium, manganese and zinc

Question 28

Which vitamins may patients choose for joints?

Answer 28

vitamin C contributes to normal collagen formation and cartilage function

Question 29

Which vitamins may patient choose for muscles?

Answer 29

calcium, magnesium, potassium and vitamin D

Question 30

What is the only lipid-formulated ibuprofen called?

Answer 30

FLARIN - it is as effective as twice the dose of standard ibuprofen

Question 31

With FLARIN, what does the lipid formulation help to do?

Answer 31

helps shield the stomach from damage. No other ibuprofen proven to be more effective for joint pain.

Question 32

What age is FLARIN suitable for?

Answer 32

Suitable for adults and children aged 12 years or over