temperature when the temperature is elevated (Gerriets et al., 2023). Acetaminophen is used for the relief of fever as well as aches and pains associated with many conditions. Acetaminophen relieves pain in mild arthritis but has no effect on the underlying inflammation, redness and swelling of the joint. If the pain is not due to inflammation, acetaminophen is as effective as aspirin. It is as effective as the nonsteroidal anti-inflammatory drug ibuprofen in relieving the pain of osteoarthritis of the knee (Gerriets et al., 2023). Acetaminophen is metabolized (eliminated by conversion to other chemicals) by the liver. Therefore, drugs that increase the action of liver enzymes that metabolize acetaminophen (e.g., carbamazepine, isoniazid, rifampin) may decrease the action of acetaminophen. The potential for acetaminophen to harm the liver is increased when it is combined with alcohol or drugs that also harm the liver. When used appropriately, side effects are rare. The most serious side effect is liver damage due to large doses, chronic use, or concomitant use with alcohol or other drugs that also damage the liver (Gerriets et al., 2023). Acetaminophen is excreted in breast milk in small quantities. However, acetaminophen use by the nursing mother appears to be safe. Acetaminophen has been used in all stages of pregnancy (Gerriets et al., 2023). Be sure you are ready to design a treatment plan working entirely in the supine position or even sitting position, with extra pillows to prop up the head and chest of the client. The general circulatory benefits of manual therapy may be helpful to heal pregnancy induced hemorrhoids, even though therapists should never work directly on or near the affected area. The most common pain conditions that pregnant women can experience during pregnancy are lower back pain, joint and ligament pain, and headaches. Acetaminophen (paracetamol, Tylenol ® ) is generally considered safe to treat any of these pain conditions but should be monitored and approved by a doctor. NSAIDs or prescription pain medications are not available to women during pregnancy because they can have negative side effects on the fetus. In addition to therapeutic massage, acupuncture, yoga, pelvic or physical therapy, and regular exercise are options for pregnant women to treat pain. Therapeutic massage is a very effective treatment for back pain for a pregnant woman. Applied correctly by avoiding pressure points that could activate contractions, even deep tissue or trigger point techniques can be safely used from the second trimester on to relieve muscle tension. For ligament pain, gentle circular techniques and stretching can be applied to help release joints and help reduce pain. For headaches, circulatory massage, and scalp or sacral massage, occiput tension releases and reflexology are particularly helpful for reducing symptoms. Manual therapy for pregnant women is a safe and effective alternative for women who are suffering from either pain and or GI conditions throughout their pregnancy. It is recommended to receive proper training or certifications before offering prenatal massage or therapy. Working together with the primary care doctor or obstetrician gynecologist can be an excellent way to create a cohesive treatment plan for therapists.
Acetaminophen is administered orally with absorption associated with the rate of gastric emptying. Peak blood concentrations usually occur within one-half to one hour. In large doses, a highly active metabolite is associated with acetaminophen’s toxicity to the liver and kidneys. The half-life of this drug is two to three hours and is generally unaffected by renal function. With large doses or in the case of liver disease, the half-life duration may double (Gerriets et al., 2023). Unlike NSAIDs, acetaminophen does not have anti- inflammatory properties, so it does not affect uric acid levels and platelet function. Patients allergic to aspirin, those unable to take salicylates, individuals with hemophilia, a history of peptic ulcer, or those with aspirin-associated bronchospasms should not take acetaminophen. It is also often used in children with viral infections. Larger doses may cause dizziness, excitement, and disorientation. Early symptoms of hepatic damage include nausea, diarrhea, vomiting, and abdominal pain. There have also been rare cases of renal damage (Gerriets et al., 2023). The exact mechanism of action of acetaminophen is not known. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before it is felt by a person. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body’s Pregnancy associated pain and GI conditions Pregnancy most often is accompanied with both pain and gastrointestinal conditions throughout all three trimesters. Many medications that would normally treat these conditions are not available for women during pregnancy as they pose adverse side effects to the fetus. This leaves the pregnant woman to seek alternatives to medication to treat symptoms of both conditions. One effective and safe way to help a woman with these symptoms is therapeutic massage and/or pelvic floor therapy. It is important to note that pregnancy is unique to each individual, and not all of these conditions or symptoms may apply. It is important to consider risk factors, stage of pregnancy, and doctor’s recommendations before creating a treatment plan. Common gastrointestinal conditions that can affect a woman throughout pregnancy are heartburn, nausea/vomiting, hemorrhoids, and abdominal cramping. As mentioned, medications that are available to treat the heartburn and nausea/vomiting are antacids containing calcium carbonate or magnesium. These are typically safe for use in pregnant woman with supervision and recommendation from a doctor. Doxylamine may be prescribed in cases of sever morning sickness and vomiting. For both conditions, one of the first lines of defense can be B-6 supplements and ginger. For hemorrhoids, baths, a high fiber diet, and cortisones creams are all perfectly safe options as treatments. Therapeutic massage can be a very helpful alternative therapy for women who are suffering from any of the GI conditions. Treating the acupressure point Pericardium 6 on the wrists, reflexology, and gentle cranial sacral massage can help alleviate nausea and vomiting (Memorial Sloan Kettering Cancer Center, 2022). For heartburn, gentle downward strokes from the throat and chest can help soothe muscle tension that contributes to heartburn. For someone who is actively experiencing heartburn and is pregnant, prone positions (even if you have a pregnancy sling table) or side lying position may not be available.
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