From the Guidelines
Toradol (ketorolac) can be used for acute hip or hamstring injury pain, as evidenced by its effectiveness in reducing pain and inflammation in musculoskeletal injuries, as seen in a study comparing ketorolac to acetaminophen-codeine 1. The typical dose for adults is 10 mg orally every 4-6 hours as needed, not exceeding 40 mg per day, which is supported by the study that used a dose of 10 mg orally 1. Some key points to consider when using Toradol for acute hip or hamstring injury pain include:
- Limiting oral therapy to a maximum of 5 days due to increased risk of serious gastrointestinal, cardiovascular, and kidney side effects with longer use
- Avoiding use in patients with kidney problems, history of stomach ulcers, bleeding disorders, or those taking blood thinners
- Combining Toradol with the RICE protocol (Rest, Ice, Compression, Elevation) for optimal management of acute musculoskeletal injuries
- Using Toradol as part of a comprehensive treatment plan that may include physical therapy once the acute phase has passed It's also important to note that while Toradol was found to be effective in reducing pain, it was not superior to acetaminophen-codeine in terms of analgesic efficacy, and had a higher rate of adverse drug events 1.
From the Research
Toradol for Acute Hip or Hamstring Injury Pain
- Toradol, also known as ketorolac, is a nonsteroidal anti-inflammatory drug (NSAID) with strong analgesic activity 2.
- The analgesic efficacy of ketorolac has been extensively evaluated in various acute pain states, including postoperative pain and emergency department settings 2, 3.
- Ketorolac has been shown to provide relief from mild to severe pain in the majority of patients, with similar analgesic efficacy to that of standard dosages of morphine and other opioids 2, 4.
- However, the use of ketorolac for acute pain may be limited due to its prolonged onset of action (30-60 minutes) and the significant number of patients who exhibit little or no response 3.
Efficacy for Acute Hip or Hamstring Injury Pain
- There is limited specific evidence on the use of ketorolac for acute hip or hamstring injury pain.
- However, ketorolac has been shown to be effective in managing acute postoperative pain, including orthopedic surgery 4.
- A systematic review of ketorolac dosing strategies for emergency department patients with acute pain found that low-dose parenteral ketorolac (15-20 mg) was probably as effective as high-dose ketorolac (≥30 mg) in relieving pain 5.
Safety Considerations
- The tolerability profile of ketorolac parallels that of other NSAIDs, with most clinically important adverse events affecting the gastrointestinal tract and/or renal or hematological function 2.
- The use of NSAIDs, including ketorolac, has been associated with an increased risk of gastrointestinal and cardiovascular adverse events 6.
- The risk of adverse events with ketorolac may be increased with high dosages or prolonged use, especially in elderly patients 2, 6.