Multiple approaches to pain can add up to effective relief
In multimodal pain management, pharmacologic and nonpharmacologic approaches can complement one another when used in combination.1
Recommend TYLENOL®, a pain reliever that is safe and effective when used as directed. And round out your patient’s pain management plan with appropriate multimodal techniques that can reduce stress and address other factors that may exacerbate pain.
For patients with back pain, experts recommend pharmacologic interventions combined with lifestyle changes, physiotherapy, and nonpharmacologic methods.2 Recommend TYLENOL® in addition to these techniques:
Ice for the first 48 hours, 5 to 10 minutes at a time
Heating pad or hot shower after 48 hours
Gentle yoga1
Physical therapy, massage, or chiropractic adjustment3
Encourage lifestyle changes
In a study, patients with back pain who changed their lifestyle — such as reducing smoking and alcohol and increasing physical activity — achieved better results in nonpharmacologic treatment and experienced higher pain alleviation compared to the patients treated by medications only.2
Muscle, tendon, and ligament pain can interfere with patients’ exercise routines, sometimes causing a decrease in motivation and overall fitness. To get patients moving again, recommend TYLENOL® in addition to these techniques:
RICE: rest, ice, compression, and elevation1
Stretching
When appropriate, topical analgesics (such as BENGAY®)4
Prevention is key
Counsel your patients to take these preventative measures in order to avoid muscle aches and pains:
Stretch before and after exercise
Do a few minutes of mild warm up and cool down before and after vigorous exercise
Increase level of difficulty in small increments, not big leaps
Drink lots of fluids before, during, and after exercise
At work, vary activities as much as possible, and try to stretch at least once every hour
Headaches are common and often debilitating, with significant socioeconomic and personal impacts.5 Patients who take OTC pain relievers more than 3 times a week on a regular basis can experience medication-overuse headaches.6 Screen patients for overuse, and counsel them to combine pain relievers with nonpharmacologic treatments such as:
Hot shower or bath; heating pad applied to head and neck muscles
Ice pack or cool compress on the forehead
Gentle massage of the temples, scalp, neck, and shoulders7
Relaxation techniques: deep breathing, guided imagery, or progressive muscle relaxation7,8
Walking
Help patients cope
The diagnosis and treatment of chronic headaches is not always quick, and this can cause emotional stress in patients. Suggest some of these measures which can help patients regain a sense of control over their situation6:
Join a headache support group
Relax whenever possible to ease stress and related symptoms
Get enough sleep
Regularly perform aerobic exercises
Eat a regularly scheduled, healthy diet that avoids food triggers
Experts recommend using multiple treatment methods to reduce pain and improve joint function in patients with osteoarthritis.9 In one study, TYLENOL® has demonstrated analgesic efficacy in osteoarthritis, even when inflammation was present — making it an important part of a well-rounded pain management plan that can also include10:
Weight loss: losing 1 pound takes 4 pounds of pressure off knees11
Exercise12
When appropriate, topical analgesics (such as BENGAY®)4
Joint protection through proper sitting, standing, and lifting techniques
The free online program includes actionable ways for OA patients to lose weight, exercise, and protect joints.
Psychological Factors
Research shows that most patients with chronic pain experience emotional distress — most commonly, feelings of anxiety and depression. These negative moods may affect biological and behavioral responses, producing a vicious cycle that can lead to disability and reduced quality of life.13
Since early identification of psychosocial problems may help prevent pain from becoming chronic, it’s important to ask patients how they’re feeling and, when necessary, refer them to an appropriately trained specialist for further evaluation.14
For powerful pain relief, recommend TYLENOL® as a foundation of an individualized multimodal plan.
TYLENOL® is safe and effective when used as directed.
Proven analgesic efficacy in OA — even when inflammation is present10
Appropriate choice for many patients, including those on aspirin heart therapy and those with history of GI problems or kidney dysfunction15-20
Won’t increase the risk of heart attack, heart failure, and stroke the way ibuprofen or naproxen sodium can21
REFERENCES:1. US Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations. May 9, 2019. Accessed October 23, 2020. https://www.hhs.gov/sites/default/files/pmtf-final-report-2019-05-23.pdf 2. Ondrejkovicova A, Petrovics G, Svitkova K, Balogh V. Is non-pharmacological treatment an effective option for chronic low back pain? Neuro Endocrinol Lett. 2017;38(3):169-172. 3. Qaseem A, Wilt TJ, McLean RM, Forciea MA; for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a Clinical Practice Guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. 4. Derry S, Wiffen Pj, Kalso EA, et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;5(5):CD008609. 5. Lacerenza MR, Schoss F, Grazzi L. The multimodal treatment in headaches. J Headache Pain. 2015;16(Suppl 1):A47. 6. National Institute of Neurological Disorders and Stroke. Headache: hope through research. Accessed October 23, 2020. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research#3138_2. April 2016 7. Mayo Clinic. Tension-type headaches: self-care measures for relief. Updated August 21, 2020. Accessed October 23, 2020. http://www.mayoclinic.org/diseases-conditions/tension-headache/in-depth/headaches/art-20047631?pg=2 8. Cleveland Clinic. Relaxation and other alternative approaches for managing headaches. Reviewed December 28, 2012. Accessed October 23, 2020. http://my.clevelandclinic.org/health/articles/relaxation-and-other-alternative-approaches-for-managing-headaches 9. Brander V. Changing the treatment paradigm: moving to multimodal and integrated osteoarthritis disease management. J Fam Pract. 2011;60(11, Suppl 2):S41-S47. 10. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992;19(12):1950-1954. 11. Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52(7):2026-2032. 12. Penninx BWJH, Messier SP, Rejeski WJ, et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161(19):2309-2316. 13. Shuchang H, Mingwei H, Hongxiao J, et al. Emotional and neurobehavioural status in chronic pain patients. Pain Res Manag. 2011;16(1):41-43. doi:10.1155/2011/825636 14. Nadler SF. Nonpharmacologic management of pain. J Am Osteopath Assoc. 2004;104(11 suppl 8):S6-S12. 15. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001;345(25):1809-1817. 16. Hoftiezer JW, O’Laughlin JC, Ivey KJ. Effects of 24 hours of aspirin, bufferin, paracetamol and placebo on normal human gastroduodenal mucosa. Gut. 1982;23(8):692-697. 17. Blot WJ, McLaughlin JK. Over the counter non-steroidal anti-inflammatory drugs and risk of gastrointestinal bleeding. J Epidemiol Biostat. 2000;5(2):137-142. 18. US National Library of Medicine. Naproxen. Revised July 15, 2016. Accessed October 23, 2020. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a681029.html 19. Frech EJ, Go MF. Treatment and chemoprevention of NSAID-associated gastrointestinal complications. Ther Clin Risk Manag. 2009;5(1):65-73. 20. Henrich WL, Agodoa LE, Barrett B, et al. Analgesics and the kidney: summary and recommendations to the Scientific Advisory Board of the National Kidney Foundation from an Ad Hoc Committee of the National Kidney Foundation. Am J Kidney Dis. 1996;27(1):162-165. 21. US Food and Drug Administration. FDA strengthens warning of heart attack and stroke risk for non-steroidal antiinflammatory drugs. Reviewed June 9, 2016. Accessed October 23, 2020. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm453610.htm
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