patients who experience Osgood-Schlatter disease, pain medication would often be looked at as a last resort by doctors. As a manual therapist, you would want to focus on stretching the quadricep muscles, relaxing the hamstrings, and applying cross fiber frictions and circulatory techniques around the knee and surrounding cartilage. Myofascial release on the tibialis anterior and other shin muscles is extremely helpful as well, especially with the prevention of formation of shin splints, a common secondary condition that can occur with someone with Osgood-Schlatter disease (Boston Children’s Hospital, 2023). Healthcare Consideration: When someone who has Osgood-Schlatter disease comes for therapy, they are likely a minor. It is extra important when working with this population that you inform them and their guardian on the benefits of manual and physical therapy while explaining the treatment plan, areas you will work on, and techniques you will use prior to the start of their session. Receiving parental consent to treat is also an imperative part of working with minors. You can suggest to your patient that they come in shorts and a t-shirt to avoid having to deal with draping during manual therapy.
of jumping and high impact on the knee (Boston Children’s Hospital, 2023). Pain symptoms of Osgood-Schlatter are described as pain and tenderness below the knee and can be accompanied by painful popping and clicking and limping. Osgood- Schlatter is easily misdiagnosed as patellar tendonitis, so it is important to receive a confirmed diagnosis from an orthopedic doctor. Bone scans, x-rays, or MRIs can differentiate clearly between these two pathologies as the bump on the shin bone will be clearly displayed with the presence of Osgood-Schlatter (Boston Children’s Hospital, 2023). Treatment of this painful condition will vary based on the severity of the condition and age and activity of the child in question. Utilizing knee braces or kinesiology taping can help give support to the knee muscles and tendons. Some cases may call for a complete change in activity, and others may look to therapeutic massage and physical therapy for relief of symptoms. In almost all cases, time is the key factor. As the muscle and tendons catch up to the bone growth, the symptoms will taper off, although the bump on the shin may remain indefinitely (Boston Children’s Hospital, 2023). Manual therapy can be a very beneficial pain relief therapy for those with this condition. Considering the age of the
PAIN MEDICATIONS INTRODUCTION
chronic pain. Subsequently, we will look at the difference between different medications, some of the common names, and their side effects. Pain medications in general are not total contraindications for therapeutic massage but require caution. Both over-the-counter and prescription pain medications can interfere with the client’s ability to give proper feedback about pressure. Deep tissue work is contraindicated unless the medication can be timed to be taken after the session. of potentially serious side effects. The most common is irritation of the stomach (Ghlichloo & Gerriets, 2023). NSAIDs are very useful in treating joint pain, swelling, and muscle pain. Although all NSAIDs appear to work in the same way, not every medication has the same effect on every person. Individuals should use only one NSAID at any given time. Most NSAIDS are an appropriate treatment for chronic conditions such as arthritis, muscle pain, gout, sprains, and strains. The most common side effect from NSAIDs is stomach upset or indigestion, especially in older patients. Taking NSAIDs with food or immediately following a meal lessens the chance of this occurring. Some NSAIDs products are less likely to upset the stomach. NSAIDs also prevent platelets (blood cells that help blood clot after an injury) from working correctly. When platelets don’t function as they should, bleeding is more difficult to stop. NSAIDs can also irritate the stomach, causing GI ulcers and bleeding. Stools that are darker than normal or unusual bruising, are both signs of bleeding, and a client who experiences these should be referred to a doctor. Other side effects include kidney and liver problems (Ghlichloo & Gerriets, 2023). NSAIDs should be used only under CLOSE physician supervision if a patient: ● Has asthma.
Pain medications are available both over the counter and as prescription drugs. Over-the-counter pain oral medications are commonly taken to treat more common pain conditions such as headaches, backaches, and joint pain, or to reduce inflammation and fever. You may be familiar with the most common of these medications such as acetaminophen or ibuprofen. Prescription pain medications are now being distributed and prescribed less frequently due to the opioid crisis. Prescription pain medications can be habit forming and should only be used to treat severe acute and Nonsteroidal anti-inflammatory drugs (NSAIDs) Many anti-inflammatory medications are nonopioid analgesics and are available without a prescription. Doctors often find them appropriate for the treatment of acute and chronic effects. People with inflammation should be treated for both relief from pain and to slow or limit damage to the tissues that is the underlying cause. Nonsteroidal anti- inflammatory drugs (NSAIDs) can reduce inflammation for varying lengths of time. NSAIDs are typically divided into groups based on their chemical structure and selectivity. Diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), and ibuprofen (Motrin, Advil) are just some examples of nonsteroidal anti-inflammatory drugs (Ghlichloo & Gerriets, 2023). The common anti-inflammatory drugs (like aspirin, ibuprofen, and naproxen) all act by blocking the action of both the COX-1 and COX-2 enzymes. Blocking the COX-2 enzyme impedes the production of the prostaglandins that cause the pain and swelling of arthritis inflammation (Eustice, 2022). The NSAIDs include a large and chemically diverse group of drugs that possess analgesic, anti-inflammatory, and antipyretic (fever-reducing) properties. There are dozens of NSAIDs on the market, with new ones constantly becoming available. Some can be purchased as over-the-counter preparations, but larger doses of those drugs or other preparations are available only by prescription. The anti- inflammatory abilities of NSAIDS function by inhibiting the production of prostaglandins, which are responsible for producing inflammation and pain. NSAIDs have a number
● Has liver problems. ● Has heart problems. ● Has kidney problems.
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