Topical Pain Relief April.LN G__Layout 1 14/04/2015 11:39 Page 1 Education
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OTC_topical pain relief_april.LN_G__Layout 1 14/04/2015 11:39 Page 1 education Supporting Training Initiatives the otc exce ing lle in n a c r e t • in Quality Seal IG treatment clinic a s 2015 C so th ciation wi Common conditions and their treatment options This module has been endorsed with the NPA’s Training Seal as suitable for use by medicines counter assistants as part of their ongoing learning. Complete the questions at the end to include in your self-development portfolio module 216 Welcome to TM’s OTC topical pain relief Treatment Clinic series. This handy, four-page section is specially designed so that author: Jane Feely, PhD you can detach it from the magazine and keep it for future reference. for this module Each month, TM covers a different OTC treatment area OBJECTIVES: After studying this module, assistants will: to help you keep up-to-date • Be familiar with the common causes of musculoskeletal pain with the latest product • Be able to advise on the OTC products available to help relieve common symptoms developments. In this issue, • Know when to recommend cold or heat therapy we focus on topical pain • Know which customers to refer to the pharmacist relief. At the end of the • Be able to offer self care tips to prevent injury. module there are multiple choice questions for you to complete, so your progress Countless charity campaigns and awareness weeks pain according to its origin. Here, we mainly focus can be monitored by your promote the importance of living a healthy, active on musculoskeletal pain, which is pain, soreness or pharmacist. lifestyle. Yet few of us focus on the unexpected discomfort felt in the muscles or joints (e.g. a twisted You can find out more in muscular aches and pains that can accompany that ankle or pulled hamstring). the Counter Intelligence Plus trip to the gym or that jog around the park. Pain can also be classified by its duration: training guide. According to Pain UK, 10 million people in the l Acute pain is short term (e.g. a sprained ankle) UK live with pain. For some, this is the result of a l Chronic pain is long term (e.g. arthritis). The last six topics we have serious, chronic condition such as cancer, whereas Pain occurs for a reason and should not be covered are: for others it comes from poor posture or sleeping ignored. It’s also very common and can interfere l Smoking cessation incorrectly, and for many it’s due to a sprain or strain with normal, everyday activities. According to l Oral care contracted during sport. Whatever the cause, this Arthritis Research UK, musculoskeletal pain affects l Daily fatigue and stress month’s OTC Treatment Clinic focuses on the topical a large proportion of the population. One study l Dry skin and eczema pain relief products available to help ease pain and revealed that 69 per cent of women and 66 per cent l Insomnia the self care tips you can pass on to customers. of men aged 50 to 59 had experienced pain lasting l Coughs a day or longer at some point during the previous You can complete previous Different types of pain four weeks. A separate study revealed that chronic modules online at: Pain is something we’ve all experienced – a bumped pain, which persists continuously or intermittently www.tmmagazine.co.uk elbow, cut finger or a pulled muscle are all common for more than three months, affects at least 10 per causes. Healthcare professionals (HCPs) often classify cent of the population. TM APRIL 2015 PULL OUT AND KEEP OTC_topical pain relief_april.LN_G__Layout 1 14/04/2015 11:39 Page 2 the otc treatment clinic (where the spine curves to the side) can cause back pain. Arthritis and osteoporosis can also reflective exercise affect the lower back • Pre-existing conditions: pain from other conditions may be felt in the lower back. These later saying that although her back pain has include kidney infections or stones, Sue, 55, comes to the pharmacy for a improved, she has developed a pain down her endometriosis, ovarian cysts, uterine fibroids and product to ease her back pain. She has left leg and a tingling sensation in her foot. She cancer of the spine. Pregnancy is another been gardening recently and giving the adds that although the pain is agonising, it common cause. house a thorough clean. She also has an tends to come and go. For the majority of people, back pain is not office job that she drives to every day. serious and usually resolves within six weeks. She’s reluctant to take painkillers as she Considering Sue’s earlier symptoms, she could However, BackCare estimates that in up to seven doesn’t like the idea of relying on tablets. be suffering from sciatica, which occurs when a per cent of cases, acute back pain becomes spinal disc presses on the sciatic nerve. Cases of chronic. Sufferers should be referred to the What would you recommend? sciatica often resolve on their own, although pharmacist if they have: This sounds like a case of extra and this can take several weeks. Refer Sue to the • Severe pain that does not improve unaccustomed manual activity putting a pharmacist, who may refer her to a GP. • Pain following an injury or fall strain on Sue’s back. Check Sue’s posture • Numbness or tingling and ask if she’s been doing any heavy What if: • Pain alongside fever, weakness, difficulty digging in the garden. When crouching Between referrals, the pharmacist recommends urinating or unexplained weight loss down, Sue should maintain a straight back that Sue purchases an analgesic. However, you • Swelling or redness on the back. to avoid bending. know that she has asthma. At work, Sue should check that her l Shoulder and neck pain chair is suitable. At home, an upright chair Paracetamol is a suitable painkiller for Sue. She According to NHS Choices, shoulder disorders may be the best option while relaxing in can take this as well as applying heat therapy. affect around three in 10 adults at any one time. the evenings. Sue should ensure her car Encourage Sue to be cautious of her posture Among older people, frozen shoulder is seat is comfortable and should work to and to continue doing gentle exercise when common and restricts the normal movement maintain a correct posture at all times. the pain subsides. of the joint. The rotator cuff (a group of muscles It’s important to achieve the right and tendons that surround the shoulder joint) balance between rest and gentle activity. What if: can also be affected. Walking and swimming may be suitable While in the pharmacy, Sue asks if she should Shoulder instability (where the shoulder has exercise options, although breast stroke be taking vitamin supplements. an usually large range of movement) or injury can exacerbate back pain in some cases. to the joint at the top of the shoulder can also Considering her age, Sue is likely to be post- occur. This is more common in younger people What if: menopausal and may benefit from taking and those who play sports or activities involving Lifestyle changes have been ineffective and calcium and vitamin D supplements. Following repeated shoulder movements. Sue requests additional topical pain relief. the menopause, women can suffer from A painful, stiff neck can be caused by reduced bone density and a heightened risk of sleeping in an awkward position, using a A heat pad or hot water bottle may be osteoporosis. Nutrients including calcium, computer keyboard for long periods of time or effective at easing lower back pain, vitamin D, magnesium, copper, zinc, vitamin C simply sitting in a draft. Anxiety and stress can particularly while at home in the evenings. and vitamin K are all essential for maintaining also cause tension in the neck muscles. While at work, recommend that Sue tries healthy bones throughout life. Most cases of neck and shoulder pain are a topical analgesic gel or a spray Recommend that Sue takes a calcium and minor and resolve with time. However, anyone formulation for hard to reach areas, such vitamin D supplement, as well as a multi- suffering severe or persistent pain, or whose as her lower back. vitamin and mineral supplement. Check the symptoms came on suddenly or relate to an quantity of calcium and vitamin D in the accident or fall, should be referred to the What if: multivitamin supplement to ensure that Sue pharmacist. Sue returns to the pharmacy two weeks doesn’t take too much. l Osteoarthritis Osteoarthritis (OA) is the most common type Common causes of pain increase the risk of suffering back pain, as can of arthritis in the UK. According to Arthritis l Back pain having a desk job with a poorly designed Research UK, 8.75 million people in the UK have Back pain, particularly affecting the lower back, workstation. sought treatment for OA. This includes a third of is one of the most common causes of pain in the While the exact cause of lower back pain people over 45, as well as 49 per cent of women UK. According to BackCare, the charity for back may not always be obvious, common causes and 42 per cent of men aged 75 and over. and neck pain, an estimated four out of five include: OA occurs when there is wear and tear adults experience back pain at some stage. • Muscle or ligament strain: this may occur after damage in and around the joints. It most The peak age to experience back pain is 35 an accident or fall, or following repeated heavy commonly affects the knees and hips, but can to 55 and while anyone can suffer, certain lifting or sudden, awkward movements also occur in the spine and small joints of the factors increase an individual’s susceptibility.