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Pain management and pharmacy – Part 1

National Pain Week is coming up in July, so we thought it was the perfect opportunity to talk about pain and solutions that can be found in the pharmacy for your customers.

It’s likely you see people in pain pop into the pharmacy every day looking for a solution; whether they are topping up their stock of Panadol for the occasional headache, or filling a prescription to help with long term back pain.

Pain, regardless of the type, isn’t necessarily the same for everyone. For example, two people can break their arm and have a very different pain experience. There are a number of factors affecting how pain is experienced, these include attitudes, beliefs and personality.

 

What is pain?

There are four types of pain:

Acute pain – short-lived pain that is felt in response to a cause that can easily be identified. For example, surgery, trauma, or illness. The feeling of pain is like a warning signal to let you know that injury has occurred. Acute pain usually lasts less than three months.

Sub-acute – pain that is progressing towards chronic pain, but this progression may be prevented. This is known as the transition phase.

Recurrent – pain that occurs on a cyclical basis, such as migraine or pelvic pain.

Chronic pain – is long term pain that can last months or even years after the initial injury. Chronic pain is often less to do with an injury to body tissue and more to do with what’s happening in our nervous system. Our nervous system can become sensitised and overactive, so that we continue to feel pain, even without any ongoing tissue damage.

 

Dealing with pain

There are many ways people deal with pain, dependent upon the type of pain, where it is located and the person. Customers with acute pain may be happy with a heat rub or an anti-inflammatory to get them through. Some customers suffering from long term pain may be given a pain management plan by a doctor or physiotherapist. A plan may include a mix of solutions such as combining medication with certain exercises and diet changes.

Sometimes customers need an empathetic ear, so there may be times when you find yourself listening to customers as they speak of their pain, frustration and helplessness.

 

How you can help in the pharmacy

The first thing you probably think of when someone asks you for assistance with pain is medication. It’s important that you get as much information as possible from your customer so you can recommend the right product and in some cases you will need to check with the pharmacist before selling an item.

Anti-inflammatory oral medications

Obvious options include non-steroidal anti-inflammatory (NSAIDs) like aspirin, ibuprofen, naproxen or diclofenac. These products are usually effective for relieving fever as well as mild to moderate pain accompanied by swelling or inflammation. They can be helpful for pain resulting from:

  • Muscles aches
  • Sprains
  • Strains
  • Back or neck injuries
  • Cramps
  • Gout attacks
  • Bursitis
  • Tendonitis
  • Dental pain
  • Menstrual cramps
  • Stress and tension headaches

Aspirin is also used at a low dosage to stop blood clotting and prevent strokes and heart attacks in individuals at high risk.

Recommending any NSAID medication should be taken seriously as there are some customers who shouldn’t be taking it. When you go through the Ask. Assess. Advise protocol, make sure you refer the query to the pharmacy if the customer:

  • Is over 65 or under 12 years of age
  • Has a history of stomach problems or disorders
  • Has a history of kidney problems
  • Has heart problems
  • Has high blood pressure
  • Has respiratory problems such as asthma,
  • Is allergic to ibuprofen, aspirin or other NSAIDs
  • Is pregnant or breastfeeding
  • Is using other medicines
  • Has stomach problems or issues with indigestion
Topical medications

NSAID gels, such as Nurofen or Voltaren, and topical heat rubs like Deep Heat are also great options for someone who is suffering from acute or sub-acute pain. However, topical products may not be suitable for customers who:

  • Are pregnant or breastfeeding
  • Have stomach problems (e.g. peptic ulcer or gastrointestinal bleeding)
  • Have a history of bleeding disorders
  • Have kidney diseases
  • Have asthma
  • Are allergic to aspirin
  • Are taking other medicines
  • Have skin problems

This month, we’ve covered anti-inflammatory, but there is so much more to managing pain and how you can help your customers. Check in next month, we’ll be talking about analgesics and pain management.

Sources:
SIRCPPK310 – Assist customers with analgesic and anti-inflammatory products
Pain Australia, Facts Sheet: The Nature and Science of Pain
Chronic Pain Australia, Fact Sheet.

Do you know your stuff when it comes to pain solutions in the pharmacy? Take this month’s Brain Tweezers to find out!

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