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NSAIDS & Pain Relief

Non-steroidal anti-inflammatory drugs (NSAIDs) 

  • NSAIDS are recommended for short term use only during flares of joint symptoms.
  • They are useful in reducing inflammation and pain. They can be given prior to school or activity to reduce the need for additional doses at school.
  • NSAIDs are better tolerated in children with less side effects (gastrointestinal symptoms).
  • Paracetamol can be given in combination with NSAIDs.
  • Where possible use of tablets or sugar-free preparations are recommended to reduce the risk of dental caries. An electric toothbrush may help protect oral health.
  • If pain continues to be reported then further specialist advice should be sought.
  • NSAIDS are not disease modifying but are useful in the short term for symptom relief.
  • Aspirin is very useful to treat the arthritis of Acute Rheumatic Fever.
  • High Dose Aspirin is used in Kawasaki Disease and helps to reduce aneurysm formation.

Paracetamol (Acetominophen) and non-opiate analgesics 

  • These can be helpful with pain control and if used with NSAIDs. Paracetamol is also helpful with fever and is medication that many families are familiar with for childhood intercurrent illnesses. 
  • Codeine and other non-opiate analgesics are also helpful as pain relief but do cause side effects (e.g. constipation) and need to be used with caution and for short term use. 

 Non-drug pain relief 

  • Hot / Cool Packs - for flares of joint disease.
  • Warm bath - may help relieve stiffness as well as pain.
  • TENS machine - may help with 'background' pain control.
  • Distraction techniques - may help with procedures e.g. subcutaneous injections and blood tests.

Nurses have an integral role to assess and manage pain. Key points for good practice include: 

  • Record a pain history and ensure adequate analgesia as prescribed.
  • Observe for signs of pain - verbal, non-verbal and physiological.
  • Use an age appropriate pain tool and document results in nursing notes.
  • Record pain score regularly and act upon the results.
  • Administer analgesia and record age appropriate pain score to assess effect.
  • Observe for side effects of analgesia and contact doctor as appropriate.
  • Reassure patient and family.

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