Pain after exercise
Customers may try a new piece of equipment at the gym or push themselves a little harder on their daily run only to find themselves suffering the following day. Delayed onset muscle soreness (DOMS) after physical activity is very common, particularly when beginning a new exercise programme or changing the nature, intensity or duration of the activity. DOMS may be caused by microscopic damage to the muscle fibres and many experts believe that this is the body adapting, which in time leads to greater strength and stamina.
DOMS typically occurs a day or two after exercise and lasts three to five days. It can range from mild to severe and anyone, including experienced athletes, may suffer. DOMS rarely requires medical attention unless the pain is severe or there is pronounced swelling.
Reflective exercise
Sue, 55, comes to the pharmacy for a product to ease her back pain. She has been gardening recently and giving the house a thorough clean. She also has an office job that she drives to every day.
She's reluctant to take painkillers as she doesn't like the idea of relying on tablets.
What would you recommend?
This sounds like a case of extra and unaccustomed manual activity putting a strain on Sue's back. Check Sue's posture and ask if she's been doing any heavy digging in the garden. When crouching down, Sue should maintain a straight back to avoid bending.
At work, Sue should check that her chair is suitable. At home, an upright chair may be the best option while relaxing in the evenings. Sue should ensure her car seat is comfortable and should work to maintain a correct posture at all times.
It's important to achieve the right balance between rest and gentle activity. Walking and swimming may be suitable exercise options, although breast stroke can exacerbate back pain in some cases.
What if:
Lifestyle changes have been ineffective and Sue requests additional topical pain relief. A heat pad or hot water bottle may be effective at easing lower back pain, particularly while at home in the evenings. While at work, recommend that Sue tries a topical analgesic gel or a spray formulation for hard to reach areas, such as her lower back.
What if:
Sue returns to the pharmacy two weeks later saying that although her back pain has improved, she has developed a pain down her left leg and a tingling sensation in her foot. She adds that although the pain is agonising, it tends to come and go. Considering Sue's earlier symptoms, she could be suffering from sciatica, which occurs when a spinal disc presses on the sciatic nerve.
Cases of sciatica often resolve on their own, although this can take several weeks. Refer Sue to the pharmacist, who may refer her to a GP.
What if:
Between referrals, the pharmacist recommends that Sue purchases an analgesic. However, you know that she has asthma. Paracetamol is a suitable painkiller for Sue.
She can take this as well as applying heat therapy. Encourage Sue to be cautious of her posture and to continue doing gentle exercise when the pain subsides.
What if:
While in the pharmacy, Sue asks if she should be taking vitamin supplements. Considering her age, Sue is likely to be postmenopausal and may benefit from taking calcium and vitamin D supplements. Following the menopause, women can suffer from reduced bone density and a heightened risk of osteoporosis.
Nutrients including calcium, vitamin D, magnesium, copper, zinc, vitamin C and vitamin K are all essential for maintaining healthy bones throughout life. Recommend that Sue takes a calcium and vitamin D supplement, as well as a multivitamin and mineral supplement.
Check the quantity of calcium and vitamin D in the multivitamin supplement to ensure that Sue doesn't take too much.