Team Training: Acute Pain

Source: Irish Pharmacy News, July 2025, page 66.

A community pharmacy environment that fosters teamwork ensures high levels of consumer satisfaction. This series of articles is designed for you to use as a guide to assist your team in focusing on meeting ongoing CPD targets and to identify any training needs in order to keep the knowledge and skills of you and your team up to date.

The below information, considerations and checklist provide support to enable you to run a team training session and identify opportunities for learning within the topic of Acute Pain.

The cause of pain is sometimes difficult to determine and there are often many aspects to consider. Chronic pain can be more difficult to determine the cause; acute pain more often has a more clearly identifiable cause (e.g.) muscle injury. It is the indeterminate nature that can present the biggest obstacle to health professionals to establishing proper diagnosis of the condition.

Acute pain starts quickly and lasts a short period of time. The definition of acute pain is pain that improves within one to three months of onset. Pain that lasts longer than 6 months is considered chronic pain and will require more specialist treatment from a pain expert. The period between 3 and 6 months is classified as the time of transition from acute pain to chronic pain. Patients require more specialist evaluation and treatment at this stage rather than just taking painkillers to avoid transitioning into chronic pain.

Acute pain can be felt in a specific body area such as the neck or back or the patient may have widespread pain with conditions such as a viral illness.

Acute pain may be described as:

• Sharp
• Dull
• Stabbing
• Throbbing (sign of inflammation)
• Shooting or shock-like (sign of nerve involvement)

A successful outcome from GP visits should be a pain management plan. It is highly likely that as part of this, some form of pain-relieving medication will be prescribed. Ideally, advise on promotion of self-help, self-management, and other treatments to help improve their condition and add value to the benefit offered by medication.

Given the wide and varied nature of acute and chronic pain, there is a myriad of medication options. The effectiveness of medication depends on the nature and severity of the pain.

Regarding treatment of acute pain caused by headache (ie, migraine), in addition to standard paracetamol and NSAIDs, triptans are considered the most effective to combat acute attacks if ordinary analgesics do not work. Cochrane reviews (39 in total) of randomised controlled trials on effectiveness of OTC analgesics in acute pain found reliable evidence to indicate that simple, inexpensive, and common analgesics give good pain relief to many patients with acute pain, such as headache, toothache, sprains, and strains. Data demonstrated the most efficacious OTC drugs used were ibuprofen/paracetamol combinations in respective 400mg/1000mg and 200mg/500mg doses.

These formulations gave effective relief in seven out of ten patients. Fast-acting ibuprofen 200mg and 400mg was effective in at least five out of ten patients. Paracetamol alone was effective in four out of ten patients.

The patient’s needs will affect treatment choice so pharmacists and pharmacy teams should have available (and understand) a range of guidance and literature to best advise patients about the most effective treatment for them.

Regular review of the continued suitability of all medications used by those with both acute and chronic pain is vital. For many, the pharmacy is becoming the first port of call when a health problem, especially pain-related, arises. Using some of the ideas regarding questions, pain diary etc will really help in enabling people to make better informed decisions about their own next step. Becoming familiar with local resources like physio’s, support groups, condition specific charities and sign posting these will only add value to a positive perception.

Consider

• Is the pharmacy team fully trained on the indications and benefits of all products for the treatment of acute pain?
• How are pain relief products (oral and topical) displayed in the pharmacy?
• Do we make the most of the potential for linked sales (e.g. oral and topical analgesics, food supplements, complementary therapies, support bandages)
• Am I up to date with the latest guidance?
• Am I aware which preparations are recommended first-line?

Key Points

• The causes of acute pain, including the various types of injury
• What types of pain can be considered for management in the pharmacy
• Which customers should be referred to the pharmacist
• The use of the PRICE method
• The importance of not taking certain oral analgesics for longer than three days without referral
• Questions to ask the customer
• The role of dietary supplements

Actions

• Ensure support staff understand the following key points:
• The common types of acute pain
• The characteristics of a good analgesic for OTC use in the treatment of acute pain
• The benefits and limitations of OTC medicines
• The importance of what outcome a patient presenting with pain wants
• Lifestyle issues that may impact on pain recovery, and tips on improving lifestyle
• What approaches are recommended by the World Health Organisation (WHO) analgesic ladder
• When to refer customers to the pharmacist.