Acute Injury Treatment

 

 Straight From the Physiotherapist’s Mouth

NON-PHARMACOLOGICAL METHODS TO TREAT ACUTE PAIN

physiotherapist or chiropractor

The following Physiotherapist’s guidelines should be followed to manage acute pain effectively:

• Protection

The painful area must be protected by taping, bandaging or bracing in order to avoid further pain and injury to the tissues. Covering scratches/lacerations reduces their exposure to environmental irritants in the surroundings, therefore reducing the level of pain.

• Rest
Rest is a vital component in the management of acute pain as it prevents the injured area from further damage, bleeding and swelling. You may usually see a physiotherapist in the first 48 hours.

• Cryotherapy (Ice)

Several research studies have reported positive effects of cold therapy in acute injuries and painful conditions (5, 6). Apply ice for 15-20 minutes every 2nd hour for the first 48-72 hours to relieve pain, swelling and bleeding.

• Compression
Compression is very effective in acute cases as it reduces Edema (Inflammatory fluid accumulation), extra bleeding and protects the injured area (7). This can be achieved with the help of a firm elastic bandage or strap. The compression is applied over the area affected below as well as above. Compression must not be too tight, as it’ll block the blood supply to the distal (further away from heart) area and can cause numbness, tingling sensations and pain. Applying compression with Ice enhances its beneficial effects greatly.

• Elevation
It is suggested that the injured or painful part should be kept at a higher level than the heart. It improves the venous return from affected part to the heart thereby removing extra fluid and waste materials from that area. Removal of wastes from painful area helps reducing the intensity of pain as they are the principal irritants of the nerve endings.

• Electric Modalities
Stimulation of nerve fibers and muscles through electric current produces very good analgesic effects. This is some sort of distraction for the nerves conducting pain signals as electric signals are conducted by the same nerves. Therefore some of the pain signals are blocked by electric current causing analgesia. A physiotherapist may use a combination of ultrasound, interferential and manual therapy to achieve faster healing time.

• Other Considerations

In patients with lack of coping strategies, pain may be exacerbated by stress and anxiety.

While applying the above strategies to manage pain, harmful factors should also be avoided for better prognosis. Most common harmful factors are; Heat, Alcohol and Exercise (Running). The patient should be referred to a qualified doctor or physiotherapist as soon as possible. The early diagnosis and treatment would accelerate recovery from the painful condition.

 

Lakemba Physiotherapist

References
1. Seers K, Carroll D. Relaxation techniques for acute pain management: a systematic review. Journal of advanced nursing. 1998;27(3):466-75.
2. Montgomery GH, DuHamel KN, Redd WH. A meta-analysis of hypnotically induced analgesia: how effective is hypnosis? The International journal of clinical and experimental hypnosis. 2000;48(2):138-53.
3. Good M, Stanton-Hicks M, Grass JA, Cranston Anderson G, Choi C, Schoolmeesters LJ, et al. Relief of postoperative pain with jaw relaxation, music and their combination. Pain. 1999;81(1-2):163-72.
4. Ellis JA, Spanos NP. Cognitive-behavioral interventions for children’s distress during bone marrow aspirations and lumbar punctures: a critical review. Journal of pain and symptom management. 1994;9(2):96-108.
5. Barber FA, McGuire DA, Click S. Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 1998;14(2):130-5.
6. Hubbard TJ, Aronson SL, Denegar CR. Does Cryotherapy Hasten Return to Participation? A Systematic Review. Journal of athletic training. 2004;39(1):88-94.
7. Block JE. Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open access journal of sports medicine. 2010;1:105-13.
8. Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. European journal of pain. 2003;7(2):181-8.