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Some of the most common minor injuries pharmacy teams are called to advise upon are superficial cuts and grazes. Jacquie Lee, medication safety officer and information pharmacist for Numark offers some general advice.
“The first line of treatment is cleaning the wound with mild soap and water and tapping dry with a clean towel before applying a dressing/bandage,” she says. “Antiseptics should only be used for a short time, and if the wound isn’t healing, medical attention should be sought.”
Ms Lee adds that pharmacies should keep a range of suitable dressings in stock, from plasters designed for small, superficial cuts to more complex dressings that promote healing for larger wounds.
Aches, pains and strains
The most common areas affected by strains and sprains are knees, wrists and ankles. Lee suggests that in addition to compression and support, pain relievers like ibuprofen and paracetamol can also help to manage pain following a sprain or strain. “But customers need to ensure that their injury is fully rested and supported properly to prevent further injury and aid recovery,” she adds.
Many people visit pharmacies looking for advice on treating sports and other injuries because they don’t want to bother their GP, or simply can’t get an appointment. Some common causes of sports injuries include:
- Inadequate warm-up and cool-down
- Insufficient rest and recovery
- Poor technique
- Overuse and repetitive motions
- Environmental factors like playing on uneven surfaces, extreme weather conditions, or with improper equipment.
“One of the most common sports injuries is blisters, particularly in runners and joggers,” says Lee. “Customers should be advised never to pierce the blister and to use dressings – particularly hydrocolloid ones especially for blisters – to protect it.”
Neo-G in-house physio Alex Clark explains: “Common injuries can usually be classified into three categories: direct trauma injuries, overuse injuries and long-term conditions. “Direct trauma can lead to a variety of injuries, and people are usually aware of the cause of the injury and when it happened.
“Overuse injuries are also widespread and often muscle-related. These usually occur when someone has pushed their body further than it can adapt to without adequate rest and recovery, like running a 5km race after years of inactivity.
“Long-term conditions like arthritis can develop naturally, but can also be the result of direct trauma.”
Clark advises asking the customer how their injury occurred. “This is particularly important for direct trauma injuries,” he says. “In the vast majority of occasions, a support would be required in the same region of the body as the injury, but not always. If someone presents with direct trauma to the knee and a minor ligament sprain, it could be misalignment in the ankle that’s putting the knee in a compromised position. “Using a knee support on its own may improve the injury, but the knee joint will still be compromised, and ongoing knee pain would be likely.”
He says it is also important to find out when the injury occurred, as well as whether the customer has tried any other remedies and if it is a recurring injury – this is a key question because extra reinforcement may be required for more frequent injuries.
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The Welsh Common Ailments Service
In Wales, the Common Ailments Service (CAS) offers a service that England is (according to Jonathan Rees, the National Pharmacy Association’s representation manager for Wales) a few years behind Wales and Scotland in rolling out. The CAS allows people to access free advice and treatment for 26 conditions – including cuts and grazes.
Rees, a pharmacist at Penclawdd Pharmacy in north Wales, says: “The CAS is extremely popular with patients within our pharmacy. The ability to have a face-to-face consultation with a pharmacist then receive appropriate advice and treatment free of charge is ideal for patient care and prevents unnecessary GP appointments.”
He says that initial uptake was slow, but has improved over the four years his pharmacy has been providing the CAS. “It’s an excellent service for us now in terms of being a revenue driver as well as for patient benefit,” he says. “Originally, it wasn’t very well received, possibly because pharmacies were only given around £3 per consultation – there was no incentive. The pricing structure for reimbursement improved a few years ago and it became much more financially viable.”
The set-up process is simple, and enrolment involves online training. “Once you’re up and running, you have to renew your accreditation every three years,” says Mr Rees. “All you need is a consultation room and you’re ready to go.”
Plantar fasciitis
Plantar fasciitis is common, especially in people who run. The prevalence of plantar fasciitis ranges between 5.2 per cent and 17.5 per cent, according to Michael Ratcliffe from Cuxson Gerrard & Co.
Ratcliffe says the condition can be caused by a combination of many things, including a sudden increase or change in exercise; an increase in the length of time spent standing each day; a change in foot posture (e.g. if it starts to ‘roll in’ more); weight gain; tight calf muscles; weakened foot muscles; damage to the fatty, cushioning pad under the heels, or as a response to flat, unsupportive or damaged footwear.
The use of taping has been shown to provide short-term relief for plantar fasciitis. It can be used before a sporting event or spending a long time standing. Tape should be used for two to three days, and ideally applied by a podiatrist or physiotherapist.
Patients should also reduce their activity levels until the pain eases, and stretch their plantar fasciitis/calf/Achilles tendons.
Heating and cooling therapies
When it comes to treating problems with muscles and joints, Elaine Walker, senior brand manager for Deep Heat and Deep Freeze, says: “Our research shows that three in five people are confused when it comes to deciding if heat or cold therapy should be used. Pharmacy staff should ask questions about the muscle and joint health problem, the injury, how it happened, what type of pain they are feeling (such as swelling, heat, stiffness) and, importantly, how long they have had the injury or pain.”
Sammy Margo, physiotherapist and advisor to Deep Heat and Deep Freeze says: “Cold therapy should be used when a muscular pain starts, or injury happens, as it reduces inflammation and swelling.
“Immediately following injury and for the first 72 hours afterwards, use cooling therapies. These – and rest – are the most effective way to soothe minor aches and discomfort.”
After about 72 hours, it’s time to switch to warming therapy or an adhesive patch to help with muscle recovery and rehabilitation. Heat helps to improve circulation and blood and nutrient flow, helping the healing process. Heat therapy also helps with muscle rehab and can help prevent injuries from recurring. Margo adds: “Using heat before exercise loosens and soften muscles so they move more easily, reducing the risk of muscle sprain or injury.”
It’s also important for pharmacy staff to be aware of muscle and joint health problems not caused by injuries, says Walker. “A rise in working from home has led to 50 per cent of Brits using a laptop whilst sitting on a sofa or armchair, whilst 33 per cent work from their bed. It should come as no surprise that a third of 30-40 year olds who took part in the Deep Heat and Deep Freeze research poll reported an increase in back problems over the previous year.”
Views from the p3pharmacy panel
“This is always a good category for us – especially minor injuries. People often ask for an antibiotic cream to treat a wound and we have to explain why they don’t need this. They also ask should they cover a wound or leave it open? How long should I use the treatment for? Should I go to A&E? Ibuprofen gels are popular for sports injuries and Voltarol does well. Plasters and sprays, dressings and micropore tape all do well too. Ankle and knee supports are incredibly popular for sports and other joint injuries. Unless their injury is severe, we find that people come to the pharmacy first for first aid and sports injuries. We have a large stand for our support products so customers can browse these. We also display first aid products for customers to look at and we keep lots of leaflets on hand too.”
Lila Thakerar, Shaftesbury Pharmacy, Harrow
“This is fairly popular, but more for first aid than sports injuries. We get a lot of tourists in our area, so they may come in with sprained ankles or pulled muscles. We keep in a few first aid kits, but sell more of the components. Bandages, micropore tape and antiseptic gels sell best for us. Also, Voltarol gel and Fisiocrem. We keep Voltarol in stock in the larger size as this is more popular than the smaller size. Ibuleve sells well too. We also do well with Tiger Balm and Deep Heat, as well as heat patches for neck and shoulder pain. Customers will ask us what products are best for their injury and whether they need to see a doctor. Display products in different areas of your store. We keep plasters by the till for impulse purchases.”
Sarina Mughal, Day Lewis, Knightsbridge
“We are often a first port of call for first aid and sports injuries. Savlon and Germolene have always been big sellers as they can be used for a variety of complaints. I often see burns on skin and stocking a variety of options depending on severity can be useful, such as burn gels and plasters. I have noticed an increase in cases coming to the pharmacy for sports injuries, either because of increasing patient awareness of pharmacy or the demand for A&E and minor injury units. There might be scepticism to stock a wide range of dressings because they may go out of date. Check with your wholesaler or the specific company that supplies your healthcare lines that there is an agreement in place to return stock if it does go out of date. Surprisingly, some will do this.”
Ellis Nugent, Davies Chemist, Gurnos, Swansea
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