Physical Modality for Acute PainCreated by:
photo from wisegeek.com
Acute pain is one of the most common complaints in the medical field. NSAIDs , acetaminophen, and/or weak opiods are usually prescribed in combination to provide relief. There will be instances though that all three medications are contraindicated or will be risky for the patient due to co-morbidities such as uncontrolled hypertension or drug interaction with maintenance medications. In this case, we should consider giving physical modalities to provide relief. Compresses can be used to augment pain relief as adjunct to other pain relievers. Cold compress is the best option for pain within the 1st 48-72 hours. Cold pack application induces muscle relaxation by decreasing sensitivity of Golgi tendon organs and muscle spindles. It also reduces inflammation by vasoconstriction. Moreover, it alleviates pain by alterating pain transmission signals at the level of the spinal cord. It is a powerful modality when advised correctly. Here are some steps that we must advise our patients when giving cold compress instructions:
- Do not apply the compress directly over the skin. Wrap it in a towel to prevent skin burns and prolong the coldness of the compress.
- Do not lie on top of the compress because it will cause focal heating to bony prominences.
- Always gauge the compress with their sensation. If they feel it is too cold, then it is really frigid.
- Interval between compresses should be at least an hour to prevent burns.
- Discontinue if they feel a burning sensation.
For the MIMS community, what instructions do you give to ensure patient safety?