From the Guidelines
For the management of thoracic pain due to fall injury, acetaminophen (650-1000mg every 4-6 hours) or ibuprofen (400-800mg every 6-8 hours) are recommended as first-line treatments for mild to moderate pain 1.
Key Considerations
- For more severe pain, oral opioids such as oxycodone (5-10mg every 4-6 hours) or hydrocodone (5-10mg every 4-6 hours) may be considered, with treatment durations limited to 3-7 days to minimize risk of dependence 1.
- Muscle relaxants like cyclobenzaprine (5-10mg every 4-6 hours) may be used for short-term treatment of muscle spasm associated with thoracic pain 1.
- Regional anaesthetic techniques such as paravertebral block and ESP block should be strongly considered for postoperative pain management in thoracic surgery 1.
- A multimodal approach to pain management, including the use of paracetamol, NSAIDs, and opioids as rescue treatment, is recommended 1.
Important Notes
- The use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) with or without menthol gel is recommended as first-line therapy for acute pain from non–low back, musculoskeletal injuries 1.
- Thoracic epidural is not recommended due to its invasive nature and potential risks, such as hypotension, urinary retention, and lower limb weakness 1.
From the FDA Drug Label
Oxycodone hydrochloride tablets are an opioid agonist indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate
The medication recommended for thoracic pain due to a fall injury is oxycodone.
- Key points:
- Oxycodone is indicated for the management of pain severe enough to require an opioid analgesic.
- Alternative treatments should be considered inadequate before using oxycodone.
- The use of oxycodone should be reserved for patients who have not been able to tolerate or have not had adequate analgesia with alternative treatments 2
From the Research
Medication for Thoracic Pain
There are no research papers to assist in answering this question, as the provided studies focus on headache treatment.
- The study 3 compares the effects of aspirin and acetaminophen on headache intensity and relief, but does not address thoracic pain due to a fall injury.
- The study 4 discusses the effectiveness of manual therapy in treating tension-type headache, but does not provide information on medication for thoracic pain.
- Neither study provides evidence on the recommended medication for thoracic pain due to a fall injury.