What are the treatment options for arm pain?

From the Guidelines

For arm pain, the most effective initial treatment approach is to start with non-pharmacological methods such as rest, ice, compression, and elevation (RICE protocol), followed by the use of acetaminophen or NSAIDs like ibuprofen for pain and inflammation management, as recommended by 1 and 1. The treatment of arm pain depends on the underlying cause, which can range from musculoskeletal issues like tendonitis or bursitis, to degenerative joint problems such as osteoarthritis, or inflammatory conditions like rheumatoid arthritis, as noted in 1. Key considerations in managing arm pain include:

• Initial non-pharmacological approaches like physical therapy, heat or cold application, and orthotics, as suggested by 1.
• Pharmacological treatments, starting with the least risky options such as acetaminophen or aspirin at the lowest efficacious dose, especially for short-term needs, as recommended by 1.
• The use of NSAIDs, which have been shown to be effective for treating symptoms of hand osteoarthritis, but with consideration of their potential gastrointestinal and cardiovascular risks, as discussed in 1.
• For patients with increased gastrointestinal risk, the use of non-selective NSAIDs with a gastroprotective agent, or a selective COX-2 inhibitor, as advised by 1.
• The consideration of SYSADOA (such as glucosamine, chondroitin sulphate) for symptomatic benefit, though with awareness of their small effect sizes and lack of clear structure modification benefits, as mentioned in 1.
• Intra-articular injection of long-acting corticosteroid as an effective option for painful flares of OA, particularly for trapeziometacarpal joint OA, as indicated by 1. It's crucial to identify the underlying cause of arm pain to tailor the treatment approach effectively, and to seek immediate medical attention if the pain is severe, persistent, or accompanied by other concerning symptoms like chest pain or signs of infection, as would be the case in real-life clinical practice.

From the FDA Drug Label

NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain.

The treatment options for arm pain include NSAIDs such as ibuprofen, which can help reduce pain and inflammation.

• Ibuprofen is used to treat pain and inflammation from medical conditions.
• It is essential to follow the prescribed dosage and consult a healthcare provider before taking any medication, especially for prolonged periods. 2

From the Research

Treatment Options for Arm Pain

The treatment options for arm pain can vary depending on the severity and nature of the pain. Some common treatment options include:

• Medications such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids 3
• Multimodal analgesia, which involves using a combination of different medications and therapies to manage pain 4
• Cognitive strategies, such as cognitive-behavioral therapy, to help manage pain and improve mental health 4
• Physical strategies, such as ice, elevation, and transcutaneous electrical stimulation, to help reduce pain and inflammation 4
• Muscle relaxants, which can be used to treat acute and chronic pain 5

Assessment and Management of Arm Pain

Effective management of arm pain requires a structured assessment to identify the probable causes of pain and guide management 6, 7. This can involve:

• Using tools such as pain assessment scales to evaluate the severity of pain
• Conducting a physical examination to identify any underlying conditions that may be contributing to the pain
• Developing a personalized treatment plan that takes into account the individual's needs and preferences
• Using a multimodal approach to pain management, which can include a combination of medications, therapies, and lifestyle changes

Importance of Person-Centred Approach

A person-centred approach to care is essential for effective pain management 7. This involves:

• Listening to the individual's experiences and concerns
• Respecting their autonomy and involving them in decision-making
• Providing education and support to help them manage their pain and improve their overall well-being
• Continuously monitoring and evaluating the effectiveness of the treatment plan and making adjustments as needed 4, 6