Therapeutic target
Pain relief and increase in range of motion
Therapy recommendations
- Analgesia (pain relief) according to WHO staging scheme:
- Non-opioid analgesic (paracetamol, first-line agent).
- Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic.
- High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
- If necessary, also antiphlogistics / drugs that inhibit inflammatory processes (ie, non-steroidal anti-inflammatory drugs, NSAID), eg, ibuprofen.
- If necessary, also use of muscle relaxants / drugs that relax the muscles.
- See also under “Further therapy“.
Analgesics
Analgesics are pain relievers. There are several different subgroups, such as the NSAIDs (non-steroidal anti-inflammatory drugs) to which ibuprofen and ASA (acetylsalicylic acid) belong, or else the group around the non-acid analgesics paracetamol and metamizole. They are all widely used. Many preparations in these groups carry a risk of gastric ulcers (stomach ulcers) with prolonged use.
Muscle relaxants
Muscle relaxants are medications prescribed primarily for tension. In the clinic, they are used for anesthesia. Muscle relaxants include tizanidine and tolperisone.
- Red-hand letter: tolperisone is approved only for the treatment of poststroke spasticity in adults. Outside of this approved indication, for example, there is a risk for hypersensitivity reactions (up to and including anaphylactic shock) without proven benefit.
