Over The Counter (OTC)

TREATMENT FOR MUSCLE

SPRAIN & STRAINS
Presenter: Siti Noraisah Bt Kifli
24 June 2009
 INTRODUCTION
 minor injuries to the soft tissues and connective tissues
of the musculoskeletal system.

 Sprains a stretching or tearing

of ligaments, the tough, fibrous bands
of tissue that connect bones to one
another at a joint

•Strains a stretching or tearing of

muscle tissue, commonly called a pulled
muscle.
 SYMPTOMS

Sprain
Most common type:ankle sprain
Mild or minimal sprains:mild tenderness and
some swelling
Moderate sprains: obvious swelling, bruising,
significant tenderness, and difficulty walking.
Severe sprains: walking impossible and
produce marked swelling, internal bleeding
and joint instability.
Strains
muscle soreness, muscle spasm, pain, and possibly
swelling or warmth over the involved muscle.
 OTC PRODUCTS FOR TREATMENT

 Paracetamol
 NSAIDS
 Nutritional
supplements
 Miscellaneous
 Paracetamol

Analgesic
 Mild t0 moderate pain

 500-1000mg every 4-6 hours, not exceed 4g/day

 Ifthe recommended amount does not relieve the pain, try

different medication
→excessive amounts can cause liver damage
 NSAIDs

Aspirin
Analgesic & anti-inflammatory
 Mild t0 moderate pain

 300 - 900 mg every 4 - 6 hrs as required; Max 4 g daily

 Take with food to prevent stomach upset

 NSAIDs cont..
Analgesics & anti-inflammatory

 Ibuprofen (tablet/gel)
→ 200-400 mg TDS, max 2.4 g daily
 Diclofenac sodium (tablet/gel for LA)
→75-150 mg daily in 2-3 divided doses
 Mefenemic acid (tablet/capsule)
→ 250-500 mg TDS
 Naproxen (tablet)
→ initial 500 mg, then 250 mg 6-8 hrly, max 1250 mg/day
 Ketoprofen (tablet/gel/plaster,kenhancer®)
→ 150-200 mg daily in 3-4 divided doses
 NSAIDs cont..

 Not recommended for 1st line tx

→affect long term healing
→blunt the healing process by the anti-inflammatory
effect

 Some research has shown NSAIDs can lead to an earlier

return to activity
→increase risk of recurrence
→one of the roles of inflammation & pain in healing is to
limit movement to prevent further damage
 Nutritional supplements
 Calcium + magnesium
→help repair connective tissue
→500-1000 mg Ca +250-500 mg Mg 1-2
daily

Vitamin C + bioflavonoids
→required for tissue repair & fight inflammation
→bioflavonoids improves body’s ability to absord & hold on to vit C
→1000mg 4-5 times daily for 1week, then reduce to 500-1000mg 2-3
times daily till healing is complete

Zinc
→helps the healing process
→25 mg BD for 2 weeks
 Miscellaneous

 Methyl salicylate oitment/cream/patch

→analgesic

→apply to affected area BD-TDS

→formulation content
patch (SALONPAS®):Methyl salicylate, glycol salicylate,menthol, thymol, camphor,
tocopherol acetate
cream (THERMORUB®):methyl salicylate, eucalyptus oil, turpentine oil
 PRICE

 Appropriate tx of sprains & strains for the 1st 48 hrs of

injury
P: Protection
R: Rest
I: Ice
C: Compression
E: Elevation

 HARM (heat, alcohol, running exsercise, massage)

should be avoided
 REFERENCES

 Rhiannonn Braund 2006.Should NSAIDs be routinely used in the

treatment of sprains and strains?. The Pharmaceutical Journal. 276:
655-656
 Zand, J., Spreen, A., N., & Lavelle, J., B.Smart.Medicine for
Healthier Living: muscle sprain, strain and pain. 429-431
 Ministry of Health Malaysia. Drug Formulary 2008.
 Understanding Sprains and Strains: Information, Symptoms,
Treatment, and Prevention
http://www.hipusa.com/webmd/encyclopedia/sprains_strains/
 Sprains and strains
http://www.arrowclaims.com/2007/citations/sprain_strain.
 www.mimsonline.com