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module menu icon Strains and sprains consultations

STRAINS AND SPRAINS CONSULTATIONS

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IN PRACTICE

  • W

    Iqbal is in his 40s

  • W

    He has a painful wrist

  • H

    It became painful yesterday while he was gardening

  • A

    He took some paracetamol last night but they didn't really help relieve the pain

  • M

    He isn't taking any other medicines

Read each of the following 'What if...' questions then select the correct response.

He says his wrist is painful, tender and looks a bit swollen. It also feels quite weak and he is finding it difficult to use it normally.

a. It could be broken and you should refer him to A&E as a matter of urgency

It doesn't sound as if Iqbal has broken his wrist. Symptoms that could indicate a break include:13

  • Hearing a crack when the injury occurred
  • The injured body part has changed shape
  • The injury is numb, discoloured or cold to touch.

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b. It could be a strain or sprain and you can recommend an appropriate pain relief product as well as providing self-help advice.

It sounds like Iqbal has strained or sprained his wrist while he was gardening yesterday. Symptoms of a strain or sprain are:

  • Pain, tenderness or weakness
  • The injured area is swollen or bruised
  • Muscle spasms or cramping
  • The person cannot put weight on it or use it normally.

Self-care advice could include RICE therapy for the first couple of days to help reduce swelling and support the injury:

R REST Stop any exercise or activities and try not to put weight on the injury
I ICE Apply an ice pack to the injury for up to 20 minutes every 2 to 3 hours
C COMPRESSION Wrap a support bandage around the injury to support it
E ELEVATE Keep it raised on a pillow as much as possible
To help prevent swelling, he should try to avoid heat (such as hot baths and heat packs), alcohol and massages for the first couple of days.13

He describes his pain as moderate, not mild. He says he wants an effective painkiller that will work quickly. What pain relief from the list below would you choose?

a. Soluble paracetamol tablets

As he has already tried paracetamol, a combination product may be more appropriate.5

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b. Ibuprofen tablets

Ibuprofen should not be taken for 48 hours following an injury as it can slow down the healing process.13

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c. Paracetamol and codeine soluble tablets

Soluble tablets can get to work faster than paracetamol alone* and the addition of codeine may be more appropriate for his pain.

*based on absorption data

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