Arnica and the Management of Pain in Acute Musculoskeletal Extremity Injuries

Exclusion Criteria

• •Patient is diagnosed with a fracture
• •Patient has an allergy to ibuprofen
• •Patient is already on a NSAID, acetaminophen, anticoagulant or oral corticosteroid therapy for chronic pain treatment (a NSAID given in triage or use for the current injury is allowed)
• •Use of other concurrent complementary medicine therapy, e.g. massage, acupuncture, physical therapy
• •Patient has been treated for this injury in the past
• •Patient has a bleeding/bruising disorder
• •Patient is pregnant or is lactating
• •Patient has a liver or kidney disease, malignancy, infection, immunodeficiency or metabolic syndrome
• •Patient is allergic to the Asteraceae family of plants (arnica, ragweed, chrysanthemum, marigold, or daisy are the most common)
• •Patient is nonverbal, and thus unable to give a pain score
• •Patient does not have a working telephone (required for follow-up call)
• •Family requires foreign language interpreter during their ED visit