Management of Acute Musculoskeletal Pain: A Review

Objectives: Acute musculoskeletal insult (injury and surgery) is very common. It is also one of the commonest sources of acute pain. Unfortunately, this pain is also commonly undertreated. This is because of various factors that include poor understanding of the subject, fear of pharmacologic agents, there uses and limitations. Untreated acute pain evolves to chronic pain which is more difficult to treat; and the result is the younger population of workers loose valuable time and the elderly become more morbid and incapacitated. The purpose of this paper is to discuss the broad principles of multimodal and multi-agent approach to acute pain management for better patient care. Data Source: The material source is from various published articles in books and journals. Data Selection/Extraction: This is a review article on general principles. No specific data is given to compare a method or an agent with another. Conclusions: Control of acute musculoskeletal pain, whethertraumatic or postoperative is more likely to be achieved by use of modern protocols that apply existing basic techniques. Staff education and regular assessment of pain using formal scoring systems is critical. Multimodal approach should result into improved quality of care. Parenteral opioids administered by intramuscular injection or by patient-controlled analgesia devices are the recommended approach. Addition of perioperative use of non-steroidal anti-inflammatory drugs enhances pain control. Use of continuous spinal techniques is a useful alternative in selected patients. Combinations of techniques are the most effective with potential benefits in terms of overall patient outcome.