Arnica and the Management of Pain in Acute Musculoskeletal Extremity Injuries

Inclusion Criteria:

• Patient presents to the Emergency Department with an acute, soft tissue ankle orforearm injury
• ED Provider orders an X-ray for evaluation of injury
• Patient's initial pain score is of a 4 or higher
• Patient has noticeable swelling at the site of the injury

Exclusion Criteria:

• Patient is diagnosed with a fracture
• Patient has an allergy to ibuprofen
• Patient is already on a NSAID, acetaminophen, anticoagulant or oral corticosteroidtherapy for chronic pain treatment (a NSAID given in triage or use for the currentinjury 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 ormetabolic 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