What teaching can be provided to a 52-year-old female patient with achy hips and hands, who has completed immunotherapy for cancer, and has been prescribed Voltaren (diclofenac) gel, ibuprofen, and a Kenalog (triamcinolone) 40mg injection?

Pain Management Teaching for Post-Immunotherapy Patient with Joint Pain

For a 52-year-old female patient with achy hips and hands after cancer immunotherapy, the most effective teaching should include proper application of Voltaren gel, safe use of ibuprofen, understanding the effects of the Kenalog injection, and incorporating non-pharmacological pain management techniques to maximize comfort and function.

Proper Application of Voltaren (Diclofenac) Gel

• Apply Voltaren gel to clean, dry skin on painful areas of hands and hips, spreading evenly 3 times daily for optimal pain relief 1
• Wait until the treated area is completely dry (at least 30 minutes) before covering with clothing or applying other topical products like sunscreen or moisturizers 1
• Wash hands thoroughly after application, unless hands are the treatment area 1
• Avoid skin-to-skin contact between the treated areas and other people until the gel is completely dry 1
• Do not apply to open wounds, infections, or irritated skin 1
• Avoid excessive sun exposure to treated areas 1

Safe Use of Ibuprofen

• Take ibuprofen as prescribed with food to minimize gastrointestinal side effects 2
• Do not exceed recommended doses (typically 400mg per dose, maximum 3200mg daily) 2
• Be aware that combining oral NSAIDs with topical diclofenac increases risk of side effects without significantly improving pain relief 3
• Contact your healthcare provider if you experience stomach pain, heartburn, black/tarry stools, or signs of liver problems (nausea, fatigue, right upper quadrant pain, jaundice) 1

Understanding Kenalog (Triamcinolone) Injection

• The 40mg Kenalog injection should provide anti-inflammatory effects for approximately 1-3 weeks 2
• Monitor for and report any unusual side effects such as increased pain, redness, or swelling at the injection site 2
• Be aware that steroid injections work gradually - pain relief may not be immediate but should improve over several days 2

Non-Pharmacological Pain Management Techniques

• Apply heat or cold therapy to painful joints for 15-20 minutes several times daily (avoid heat with topical medications) 2
• Practice gentle range-of-motion exercises to maintain joint mobility when pain allows 2
• Use relaxation techniques including deep breathing exercises and guided imagery to help manage pain perception 2
• Consider gentle activities like walking or swimming that maintain function without excessive joint stress 2

When to Contact Your Healthcare Provider

• If pain worsens significantly or does not improve within 1-2 weeks 2
• If you experience signs of allergic reaction (difficulty breathing, swelling of face/throat) 1
• If you develop new symptoms such as numbness, tingling, or weakness 2
• If you experience concerning side effects from any medications 2, 1

Additional Important Information

• Pain management is a team effort - communicate openly with your healthcare providers about your pain levels and response to treatments 2
• There are always additional options if current treatments are not providing adequate relief 2
• Keep a pain diary to track your symptoms, medication use, and response to help guide future treatment decisions 2
• Emotional reactions to pain are normal and addressing them is an important part of pain management 2