Simple Pain Management

Basic Exercise Physiotherapy / Structure Exercise Programmes


Download

What is it and why?

  • These are first line methods to help control local pain and inflammation.

  • These simple measures are easily available and do not need a healthcare professional’s advice.

  • These measures include the local application of heat or cold, ointments, short term use of over-the-counter painkillers, walking aids or heel cushions.


  • Treatment involves Home/self-help
    Home/self-help
  • Treatment does not involve Hospital
    Hospital
  • Treatment does not involve Daycase procedure
    Daycase procedure
  • Treatment does not involve Inpatient procedure
    Inpatient procedure
  • Treatment does not involve Local anaesthetic
    Local anaesthetic
  • Treatment does not involve General anaesthetic
    General anaesthetic
  • Treatment does not involve Regional block / Spina
    Regional block / Spina
  • Pain
    Pain

    Minor

  • Mobility
    Mobility

    Improves

  • Daily activities
    Daily activities

    None

  • Driving
    Driving

    None

  • Leisure activities
    Leisure activities

    None

  • Light exercise
    Light exercise

    None

  • Heavy exercise
    Heavy exercise

    No more than usual

  • Light work
    Light work

    None

  • Heavy work
    Heavy work

    No more than usual

  • Intimate
    Intimate

    None


Overview

What does it involve?

  • Application of heat or cold or both alternatively may help relieve symptoms.

  • Applying over-the-counter ointments may help.

  • Medication, such as Paracetamol or Ibuprofen, may help if used for a short period (one or two weeks).

  • You must be aware of contraindications for taking the medications. Read the information leaflets carefully and do not exceed the recommended dose.

  • Using walking sticks will help off-load forces going through the joint. If using for hip arthritis, use it in the opposite hand. For knee arthritis, use the walking stick on the same side as the affected joint.

  • Heel cushions help decrease the forces generated at impact and may be beneficial in the early stages of arthritis.

Effort/burden

  • Effort is required to find the right combination of external applications and occasional tablets.

  • Getting the walking stick at the right height and overcoming the ‘stigma’ associated with using a walking stick.

Benefits

  • Many arthritic patients report a decrease in the intensity of pain after modifying their activities.

  • Moderate drop in pain, improvement in activities of daily living (ADL) and mobility in the long term.

  • Local anti-inflammatory gels have similar benefits as oral anti-inflammatory tablets.

  • A walking stick will help improve walking distance.

Chances of cure

  • These measures are unlikely to cure arthritis on their own.

  • However, they can improve the symptoms of arthritis, activities of daily living and mobility.

Limitations and side effects

  • There are minimal side-effects for external physical methods.

  • Oral anti-inflammatory tablets have gastrointestinal side effects.

  • Generally, Paracetamol is less effective with moderate to severe arthritis.

Risks

  • No major risks identified.

  • You may experience skin irritation from local application of medications.

  • Be aware of bleeding ulcers, exacerbation of acidity symptoms or asthma.

  • Excessive use of medications can affect renal or liver functions

Cost

  • Low cost option for both the patient and the NHS.

  • Patient: cost of over-the-counter medication and/or the purchase of a walking stick.

What if no treatment is done?

  • Arthritis will continue to deteriorate.

  • Symptoms will get worse; sometimes rapidly.

  • Will have a negative influence on other management options, e.g. surgery, in the future.


Basic Exercise Physiotherapy / Structure Exercise Programmes