Muscle and Back Pain Assessment
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Muscle and Back Pain Assessment

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Questions and Answers

The acronym WWHAM in the context of pain assessment stands for Who, What, How long, Action, and ______.

Medication

Muscular injuries often require treatment advice following the ______ method, which stands for Protect, Rest, Ice, Compression, and Elevate.

PRICE

Severe pain and immediate swelling may indicate a need for ______ in cases of muscular injuries.

referral

Tension headaches and migraines are classified under ______ in the context of pain types discussed.

<p>headaches</p> Signup and view all the answers

For patients with back pain, the risk of osteoporosis increases significantly after the age of ______.

<p>50</p> Signup and view all the answers

In children, greenstick fractures are common due to their ______ bones.

<p>flexible</p> Signup and view all the answers

Arnica is often claimed to help reduce ______ and inflammation, although its clinical effectiveness is questionable.

<p>bruising</p> Signup and view all the answers

Signs of ______ such as swelling, bruising, or inability to bear weight are indicators that may warrant referral.

<p>serious injury</p> Signup and view all the answers

Heavy smokers and women with migraine who are taking the combined oral contraceptive pill are at risk for early heart disease due to ______.

<p>hypercholesterolaemia</p> Signup and view all the answers

Patients who experience headache on ______ or more days per month due to regular use of headache medication may be suffering from medication overuse headache.

<p>15</p> Signup and view all the answers

Acute treatment of migraine is not effective if patients have tried simple analgesics and found them ______.

<p>ineffective</p> Signup and view all the answers

Women on combined oral contraceptive pills who experience migraine onset within the last ______ months may need special consideration in treatment.

<p>3</p> Signup and view all the answers

Patients who do not recover completely between migraine ______ should be evaluated for potential changes in treatment.

<p>attacks</p> Signup and view all the answers

Referral is required for chronic back pain lasting more than ______ weeks.

<p>6</p> Signup and view all the answers

Pain that radiates away from the lower back may indicate a need for ______.

<p>referral</p> Signup and view all the answers

Primary dysmenorrhoea affects over ______% of women.

<p>50</p> Signup and view all the answers

Symptoms of primary dysmenorrhoea often include cramping pain shortly before the onset of ______.

<p>bleeding</p> Signup and view all the answers

NSAIDs are very effective in treating primary dysmenorrhoea in ______% of women.

<p>80-85</p> Signup and view all the answers

Persistent pain that is progressively worsening may require a ______.

<p>referral</p> Signup and view all the answers

Incontinent patients experiencing back pain should be considered for ______.

<p>referral</p> Signup and view all the answers

Heavy or unexplained ______ may require referral in women experiencing dysmenorrhoea.

<p>bleeding</p> Signup and view all the answers

Back pain above the lumber region may be a sign that ______ is necessary.

<p>referral</p> Signup and view all the answers

Anovulatory cycles are usually ______.

<p>painless</p> Signup and view all the answers

Hyoscine Butylbromide is licensed for spasm of the __________ tract.

<p>gastrointestinal</p> Signup and view all the answers

The symptoms of a tension headache include bilateral pain and a sensation of a 'band around the __________.'

<p>head</p> Signup and view all the answers

Migraine symptoms can include __________ to light, noise, and movement.

<p>sensitivity</p> Signup and view all the answers

A __________ headache lasts between 4 to 72 hours.

<p>migraine</p> Signup and view all the answers

Important questions about headaches include onset, frequency, and __________ of pain.

<p>location</p> Signup and view all the answers

Children under 12 with a stiff neck or rash require a __________ for their headaches.

<p>referral</p> Signup and view all the answers

Triggers of tension headaches can include mental stress and excessive __________.

<p>smoking</p> Signup and view all the answers

Migraine may be preceded by an __________ in 20% of cases.

<p>aura</p> Signup and view all the answers

Referral is necessary for headache when associated with nausea and __________ in the absence of migraine symptoms.

<p>vomiting</p> Signup and view all the answers

Using a hot water bottle is one of the suggested treatments for __________ headaches.

<p>tension</p> Signup and view all the answers

Does your headache reduce your ability to work, study or ______?

<p>socialise</p> Signup and view all the answers

Triptans are part of the family of '______'.

<p>triptans</p> Signup and view all the answers

Part of the mode of action of triptans is to cause constriction of the cranial blood ______.

<p>vessels</p> Signup and view all the answers

Sumatriptan is indicated for the acute treatment of ______.

<p>migraine</p> Signup and view all the answers

The maximum dose of Sumatriptan is ______ mg in 24 hours.

<p>100</p> Signup and view all the answers

Common side effects of Sumatriptan include dizziness, drowsiness, and ______.

<p>nausea</p> Signup and view all the answers

Pharmacists must assess patients for risk of cardiovascular events or ______ when supplying Sumatriptan.

<p>IHD</p> Signup and view all the answers

Simple analgesia can include medications like paracetamol and ______.

<p>ibuprofen</p> Signup and view all the answers

Sumatriptan was deregulated to pharmacy ______ status in October 2018.

<p>OTC</p> Signup and view all the answers

According to suitability criteria, the pharmacist must assess the patient before supplying ______.

<p>Sumatriptan</p> Signup and view all the answers

Study Notes

Muscular (Soft-Tissue) Injury

  • Consider swelling, bruising, and level of pain to determine if referral is necessary
  • Higher impact forces may indicate a fracture
  • Sudden onset after trauma could indicate a tendon or ligament tear
  • If a patient is unable to bear weight on their foot, ankle or leg, refer for further medical advice
  • Consider age of patient
    • Children may have greenstick fractures
    • Elderly may have osteoporosis, osteoarthritis
  • Monitor pain for referred pain, indicating nerve root compression
  • Insidious onset and progressive pain may indicate degenerative disease

Back Pain

  • Consider age of patient:
    • Under 15: higher incidence of potentially serious causes, refer unless related to sports or schoolbags
    • 15-30: consider prolapsed disc, trauma, fractures, pregnancy, ankylosing spondylitis
    • 30-50: consider osteoarthritis, prolapsed disc, malignancy
    • Older than 50: increased risk of osteoporosis, malignancy, and metabolic bone disorders
  • Consider location, radiation, evidence of trauma, impact on mobility, factors aggravating or relieving pain, and onset timing
  • Acute, sudden onset is mostly muscle strain, refer in elderly patients
  • Insidious onset warrants referral

Period Pain (Primary Dysmenorrhea)

  • Occurs between menarche and menopause
  • 3-7 days of menstruation with a typical cycle of 28 days
  • Affects over 50% of women, 7-15% with severe cases
  • Caused by overproduction of uterine prostaglandins
    • E2 and F2-alpha

Primary Dysmenorrhea

  • Consider age of patient
    • Common in adolescents and women in their twenties
  • Consider nature of pain
    • Cramping or dull, continuous, diffuse pain?
  • Consider severity of pain
    • Rarely severe in PD
  • Consider onset of pain
    • PD starts shortly before or within 24 hours of menses
    • Rarely lasts longer than 3 days

Headache

  • Consider onset and frequency, pain location, severity, triggers, duration, and associated symptoms
  • Refer for headaches in children under 12 with a stiff neck or rash, after trauma, with nausea/vomiting in absence of migraine symptoms, with neurological symptoms, new or severe headaches in people over 50, progressive worsening, sudden and/or severe onset, headaches unresponsive to analgesics, headaches lasting longer than 2 weeks

Tension Headache

  • Bilateral
  • Pain over the top of the head
  • 'Band around the head', 'weight pressing down'
  • Non-pulsating, gradual onset, worsens over time
  • Affects 4 times as many women as men

Migraine

  • Unilateral
  • Severe
  • Throbbing
  • Lasts 4-72 hours
  • Nausea (almost all), vomiting (1/3)
  • Preceded by aura in 20%
    • Nausea, vomiting, visual disturbances (90% of auras)
    • Sensitivity to light, noise, movement

Sumatriptan

  • Deregulated to pharmacy OTC status in October 2018
  • 50mg tablets
  • Pharmacist consultation required
  • Strict suitability criteria need to be assessed
  • Storage in Pharmacy
  • 5HT1 agonists, stimulating 5HT1B and 5HT1D receptors
  • Constricts cranial blood vessels, stops inflammatory neurotransmitter release, and reduces pain signal transmission

Medication Overuse Headache

  • Prolonged use of any painkiller for headaches can make them worse
  • Defined as headaches occurring on 15 or more days per month as a consequence of regular use of headache medication for more than 3 months
  • Requires referral to a doctor

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Description

This quiz focuses on the assessment of muscular injuries and back pain, emphasizing the importance of considering patient age and trauma history. It covers signs of serious injury, conditions like osteoporosis, and specific pain indicators that may guide referrals for further medical evaluation.

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