Analgesia in soft-tissue injury: current practice in Auckland is not supported by the available evidence.

Abstract

AIMS:

To document current prescribing habits and attitudes of doctors in the Auckland region towards analgesic medication for soft-tissue injury and determine whether the available evidence supports this practice.

METHOD:

A survey of 573 doctors in the Auckland region was conducted. There was a 71.4% response rate. The clinical and experimental evidence concerning non-steroidal, anti-inflammatory (NSAID) use in soft-tissue injury was reviewed. The side-effect profiles of NSAIDs were reviewed, with emphasis on the incidence of gastrointestinal side-effects when NSAIDs are prescribed for short periods and evidence implicating adverse renal effects on healthy exercising adults.

RESULTS:

Most doctors ranked NSAIDs more effective than paracetamol (70.4%, p<0.01). NSAIDs were the most prescribed single analgesic agents (47.8%, p<0.0001). Diclofenac was the NSAID of choice for 69.8% of doctors, who used NSAIDs (p<0.001). The incidence of gastrointestinal side-effects for short-term use of NSAIDs in acute soft tissue was 11%.

CONCLUSION:

The available evidence does not support the belief by the doctors surveyed that NSAIDs are more effective than paracetamol in soft-tissue injury. NSAIDs delay, but do not prevent the inflammatory response in injured tissue and may expose athletes to an increased risk of re-injury by delaying healing. Significant adverse effects do occur in previously healthy patients who receive NSAIDs.

• Authors: P G Jones
• Journal: The New Zealand medical journal (N Z Med J) Vol. 112 Issue 1097 Pg. 376-9 (Oct 08 1999) ISSN: 0028-8446 [Print] New Zealand
• PMID: 10587068 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Non-Narcotic
• Anti-Inflammatory Agents, Non-Steroidal
• Diclofenac
• Acetaminophen

Topics

• Acetaminophen (therapeutic use)
• Adult
• Analgesia
• Analgesics, Non-Narcotic (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects, therapeutic use)
• Diclofenac (therapeutic use)
• Humans
• New Zealand
• Pain (drug therapy)
• Practice Patterns, Physicians'
• Soft Tissue Injuries (drug therapy)