If you’re treating patients with acute pain, you know how tricky it can be to balance effective relief with medication safety.
Despite how common pain presentations are in primary care, acute pain management often falls short. Many patients rely only on over-the-counter (OTC) products without understanding the risks, while others are over- or undertreated due to misconceptions about oral and topical analgesics.
The good news? Evidence-based, practical strategies can help you optimize treatment safely and confidently.
What Is Acute Pain?
Acute pain comes on quickly and is often sharp or severe, acting as a signal that something may be wrong in the body. It can result from injuries, surgery, illness, trauma, or medical procedures and typically lasts from a few minutes up to six months. Once the underlying cause is addressed or heals, the pain usually goes away.
Common causes include:
- Musculoskeletal injuries (e.g., sprains, strains)
- Childbirth
- Burns
- Surgery
- Dental or headache-related pain
Why Treatment Matters
When poorly managed, acute pain can delay recovery, limit mobility, and even lead to chronic pain syndromes. It also takes a toll on sleep, mood, and overall quality of life.
Effective pain management means looking beyond “just a pill” — understanding the cause, the patient, and the pharmacology behind your treatment plan.
Oral Analgesics: Benefits and Misconceptions
When used correctly, oral analgesics are a cornerstone of acute pain management, helping to reduce pain and restore function. They are typically the first-line treatment for most mild to moderate acute pain.
- Acetaminophen: Safe and effective when used properly, with minimal GI or CV risk.
- NSAIDs (e.g., ibuprofen, naproxen): Reliable anti-inflammatory and analgesic agents, though often misunderstood.
Common misconceptions:
- “OTC means risk-free.” Even short-term NSAID use carries potential GI and cardiovascular risks, especially in older adults.
- “All NSAIDs are the same.” Different agents and doses vary in safety and efficacy.
- “Topicals don’t work.” Topical NSAIDs can be highly effective for localized pain, and carry fewer systemic side effects.
Special considerations for older adults
When managing acute pain with oral or topical analgesics, remember that age-related changes and comorbidities can increase risk.
For these patients, clinicians should:
- Start low and titrate carefully
- Limit NSAID use to the shortest effective course
- Monitor renal and GI function, especially with concurrent meds
- Use topical NSAIDs when suitable
- Incorporate non-drug approaches like physiotherapy, exercise, and heat therapy
Update your practice
MDBriefcase’s Optimizing Acute Pain Management: Oral and Topical Analgesics eCME offers a 30-minute, Mainpro+ certified refresher designed for Canadian clinicians.
You’ll learn how to:
- Clarify misconceptions about OTC and prescription analgesics
- Identify patient-specific risk factors
- Integrate oral, topical, and non-pharmacologic therapies effectively
This program has received financial support from Haleon in the form of an unrestricted educational grant.