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Adductor Strain Medication

  • Author: Marlon P Rimando, MD; Chief Editor: Consuelo T Lorenzo, MD  more...
 
Updated: Feb 10, 2016
 

Medication Summary

The goals of pharmacotherapy in adductor strain are to reduce morbidity and prevent complications. Agents of treatment include Celecoxib (Celebrex), nonsteroidal anti-inflammatory drugs (NSAIDs), skeletal muscle relaxants, and local anesthetics. Cyclooxygenase type-2 inhibitors(COX-2 inhibitors) are the drug of choice for this condition; in cases of severe pain, opioid analgesic agents may be prescribed. Muscle relaxants often are used to reduce muscle spasm after initial injury.

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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Class Summary

NSAIDs are also a drug of choice for adductor strain for this condition. In cases of severe pain, opioid analgesic agents may be prescribed. Muscle relaxants often are used to reduce muscle spasm after initial injury.

Ibuprofen (Advil, Motrin, Ibuprin, Neoprofen)

 

Ibuprofen is a member of the propionic acid group of NSAIDs. It possesses anti-inflammatory, analgesic, and antipyretic mechanisms of action and may be related to prostaglandin synthetase inhibition.

Naproxen (Anaprox, Naprelan, Naprosyn, Aleve)

 

Naproxen is used for the relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.

Ketoprofen

 

Ketoprofen is used for relief of mild to moderate pain and inflammation. Small dosages are indicated initially in small patients, elderly patients, and patients with renal or liver disease. Doses higher than 75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient's response.

Celecoxib (Celebrex)

 

Celecoxib primarily inhibits COX-2. COX-2 is considered an inducible isoenzyme, induced during pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited; thus, GI toxicity may be decreased. Seek the lowest dose of celecoxib for each patient. It is extensively metabolized in liver primarily via cytochrome P450 2C9. Celecoxib is approved by the FDA to treat osteoarthritis and rheumatoid arthritis.

Although increased cost can be a negative factor, the incidence of costly and potentially fatal GI bleeds is clearly less with COX-2 inhibitors than with traditional NSAIDs. Ongoing analysis of cost avoidance of GI bleeds will further define the populations that will find COX-2 inhibitors the most beneficial.

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Skeletal Muscle Relaxants

Class Summary

Skeletal muscle relaxants are indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute painful musculoskeletal conditions.

Cyclobenzaprine (Flexeril, Fexmid, Amrix)

 

Cyclobenzaprine is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions.

Baclofen (Lioresal, Gablofen)

 

Baclofen is metabolized in the liver and excreted primarily in urine. This agent is not a controlled substance under the Drug Enforcement Administration (DEA).

Tizanidine (Zanaflex)

 

Tizanidine is a centrally acting muscle relaxant metabolized in the liver and excreted in urine and feces. It is used in patients with predominantly upper motor neuron involvement. It is not a DEA-controlled substance.

Carisoprodol (Soma)

 

Carisoprodol is a short-acting medication that may have depressant effects at the spinal cord level.

Skeletal muscle relaxants have modest short-term benefit as adjunctive therapy for nociceptive pain associated with muscle strains and are used intermittently for diffuse and certain regional chronic pain syndromes. Long-term improvement over placebo has not been established.

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Local Anesthetics, Amides

Class Summary

Local anesthetics are used for local pain relief.

Lidocaine (Xylocaine)

 

Lidocaine decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses. It is used for relief of pain associated with postherpetic neuralgia and has been used for pain relief of many other types of pain generators as well.

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Contributor Information and Disclosures
Author

Marlon P Rimando, MD Assistant Clinical Professor, Department of Medicine, University of Hawaii, John A Burns School of Medicine

Marlon P Rimando, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, National Strength and Conditioning Association

Disclosure: Nothing to disclose.

Coauthor(s)

Bruce B Fry, DO Director, Division of Physical Medicine and Rehabilitation, Knoxville Orthopedic Clinic, St Mary's Hospital

Bruce B Fry, DO is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, North American Spine Society, American Society of Interventional Pain Physicians, International Spine Intervention Society

Disclosure: Nothing to disclose.

Robert Brunner, MD Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham School of Medicine

Robert Brunner, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Physiatric Association of Spine, Sports and Occupational Rehabilitation, American Medical Association, Southern Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD Medical Director, Senior Products, Central North Region, Humana, Inc

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Acknowledgements

Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Martin K Childers, DO, PhD Associate Professor, Department of Neurology, Wake Forest University Health Services

Martin K Childers, DO, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Congress of Rehabilitation Medicine, American Osteopathic Association, Christian Medical & Dental Society, and Federation of American Societies for Experimental Biology

Disclosure: Allergan pharma Consulting fee Consulting

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

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Lateral lunge.
Lateral lunges.
Lateral lunges.
Lateral lunges.
Lateral lunges.
X lunges. Starting position.
X lunges.
X lunges. Back to the starting position.
X lunges.
Hip flexor stretch.
Hip flexor stretch, isolation of the rectus femoris.
Elastic bandage applied to give pain relief from an adductor strain.
 
 
 
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