Page 143 - Community pharmcy practice E-book 2025

02/11/2025, 00:29

3. Musculoskeletal Injuries / Musculoskeletal Pain (minor)

Etiology
• Musculoskeletal (MSK) pain in context of minor ailments includes strains, sprains, simple
low back pain, muscle aches, minor joint pain (non-inflammatory), overuse.
• Mechanisms: trauma (twist/strain), repetitive motion/overuse, poor posture, lack of
conditioning, degenerative changes, minor injuries.
• Pharmacist role: screen for red-flags (fracture, serious joint disease, rheumatoid arthritis,
infection), provide self-care and OTC analgesic advice, refer when needed.

Symptoms
• Localised pain in muscle/ligament/tendon area, may have swelling, reduced movement,
stiffness.
• Onset may be immediate (trauma) or gradual (overuse).
• Pain aggravated by movement, relieved by rest, may have muscle spasm, tenderness on
palpation, sometimes bruising.
• In low back pain: may have stiffness in the morning, improved with movement, or after
sitting long.

Referral Cases
Pharmacist should refer if:
• Severe pain after major trauma or suspected fracture.
• Pain with neurological signs: numbness, tingling, weakness, bowel/bladder dysfunction
(e.g., cauda equina syndrome).
• Joint swelling with redness, warmth, fever (possible septic arthritis).
• Persistent pain > 2-4 weeks not improving, or worsening despite self-care.
• Pain in a child/elderly, especially with osteoporosis, cancer history or on corticosteroids.
• Suspected serious underlying disease: rheumatoid arthritis, osteomyelitis, metastatic
disease, unexplained weight loss.
• Use of anticoagulant + bruising + pain → possible hematoma.

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