The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Oral NSAIDs.
These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.
The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.
Oral NSAIDs of Medications for the Treatment of CRPS
Indications: CRPS symptoms that are severe enough to warrant medication. NSAIDs are suggested as a supplement to aerobic, strengthening, and conditioning workouts. As first-line treatments, generic ibuprofen, naproxen, or other NSAIDs from an earlier generation are typically advised. Although data suggests it is marginally less effective, acetaminophen is an acceptable substitute or can be taken in conjunction.
First, try over-the-counter (OTC) medications to see if they work. Additional generic medicines could be used as second-line treatments. When other NSAIDs are contraindicated or there is a danger of GI problems, COX-2 selective drugs are advised as a third- or fourth-line treatment; however, concurrent treatment with abortion, sucralfate, and proton pumps inhibitors are other choices for gastro-protection. Please refer to the Non-Acute Pain Medical Treatment Guideline’s NSAID-related cautions.
Frequency/Dose/Duration: Scheduled dose rather than as needed is advised for most patients to prevent negative side effects from other treatment choices, but it is acceptable to prescribe NSAIDs for mild to moderate symptoms. Due to the possibility patients should be aware of the potential side effects of long-term (greater than two months) NSAID use. be regularly checked for negative consequences such as hypertension, blood loss, kidney insufficiency, hepatic enzyme deficiency, and elevated creatinine elevations.
Patients who are older or have co-morbid conditions can need more frequent monitoring. It can also be necessary to use a cytoprotective drug in addition.
What our office can do if you have workers compensation injuries
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