Table 3: Common Adjuvant Drugs Drug Indications
Contraindications
Side effects
Dose
Corticosteroids
Dexamethasone (Decadron)
• Allergy. • Cerebral edema. • Addison’s disease. • Tumor. • Septic shock. • Blood disorder. • Perennial allergic rhinitis.
• Uncontrolled infections. • Hypersensitivity to examethasone. • Cerebral malaria. • Systemic fungal infection. • Concurrent treatment with live virus vaccines. • Systemic fungal infections. • Hypersensitivity to corticosteroids.
• Acne. • Insomnia. • Vertigo. • Increased appetite.
• Hypertension. • Increased risk of infection. • Nausea & vomiting. • Confusion.
0.75 mg to 9 mg daily.
• Weight gain. • Impaired skin healing. • Depression. • Euphoria.
• Amnesia. • Irritability. • Headaches.
Prednisone (Deltasone)
• Inflammation. • Allergy. • Autoimmune disease. • Bell’s palsy.
• Hyperglycemia. • Fluid retention.
• Insomnia. • Euphoria.
5 mg to 60 mg daily.
PAIN MANAGEMENT THROUGH PHYSICAL THERAPY
Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation, and rehabilitation. This encompasses physical, psychological, emotional, and social wellbeing [22] .” Physiotherapy is composed of numerous treatment methodologies for various medical and surgical conditions. Cryotherapy, taping, bracing, electrotherapy, manipulative techniques, and Pilates are some of the most effective physiotherapy strategies for pain management.
Physical therapy (i.e., physiotherapy) enhances an individual’s quality of life, regardless of his or her disabilities and impairments. The World Confederation for Physical Therapy defines physiotherapy as: “Physical therapy provides services to individuals and populations to develop, maintain, and restore maximum movement and functional ability throughout the lifespan. This includes providing services in circumstances where movement and function are threatened by ageing, injury, pain, diseases, disorders, conditions, or environmental factors. Functional movement is central to what it means to be healthy. Electrotherapy Electrotherapy treats a medical condition with a micro-electrical current that provides therapeutic effects. It uses a variety of equipment for various purposes including pain relief, reducing edema, reducing muscle spasms, and preserving muscle Table 4: Commonly used Electrotherapy Modalities Modality Description Indications
properties. Electrotherapy uses electrical energy to accelerate the healing process, repair tissue, and reduce pain. The mechanisms and indications of commonly used electrotherapy equipment are stated in Table 4.
Contraindications
Adverse Effects • Mild erythema. • Increased pain, together with a
Infrared therapy (IRT) [23]
• Heat modality. • Uses infrared radiation 2 types: • Luminous (short- wave infrared. • Non-luminous (long-wave infrared). • Increases blood flow to the area. • Heat modality. • Uses electromagnetic radiation. • 2 modes: • Pulse SWD (non- thermal effect). • Continuous SWD (thermal effect).
• Pain (e.g., back
• Documented malignant hyperthermia. • Dermatological conditions (scleroderma). • Impaired skin sensation. • Superficial metals. • Metal implants. • Pacemakers. • Malignancy. • Tuberculosis joints. • Over the eyes. • Impaired thermal sensation. • Unreliable patients.
• Directly over eyes. • Skin tumors. • Hemorrhage. • Acute infection. • Blood pressure abnormalities. • Severe cardiac conditions. • Acute infection or inflammation. • Venous thrombosis or phlebitis. • Pregnancy. • Menstruation. • Dermatological conditions.
pain, fibromyalgia, osteoarthritis).
• Muscle spasm. • Edema. • Prevention of pressure sores. • Healing of
burning sensation (in people with bony spurs/bony prominences).
wounds & chronic suppurative areas.
• Psoriasis.
Short-wave diathermy (SWD) [24][25]
• Pain (e.g.,back
• Mild erythema. • Increased pain. • Burning sensation.
pain, joint pains, fibromyalgia, osteoarthritis).
• Muscle spasm. • Joint stiffness. • Healing of
wounds & chronic suppurative areas.
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