Multimodal Pain Management

Multiple approaches to pain can add up to effective relief

In multimodal pain management, pharmacologic and nonpharmacologic approaches can complement one another when used in combination.1

Recommend TYLENOL®, a pain reliever that is safe and effective when used as directed. And round out your patient’s pain management plan with appropriate multimodal techniques that can reduce stress and address other factors that may exacerbate pain.

Psychological Factors

Research shows that most patients with chronic pain experience emotional distress — most commonly, feelings of anxiety and depression. These negative moods may affect biological and behavioral responses, producing a vicious cycle that can lead to disability and reduced quality of life.13

Since early identification of psychosocial problems may help prevent pain from becoming chronic, it’s important to ask patients how they’re feeling and, when necessary, refer them to an appropriately trained specialist for further evaluation.14

For powerful pain relief, recommend TYLENOL® as a foundation of an individualized multimodal plan.

TYLENOL® is safe and effective when used as directed.

  • Proven analgesic efficacy in OA — even when inflammation is present10
  • Appropriate choice for many patients, including those on aspirin heart therapy and those with history of GI problems or kidney dysfunction15-20
  • Won’t increase the risk of heart attack, heart failure, and stroke the way ibuprofen or naproxen sodium can21

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See dosages for adult TYLENOL® formulations.

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REFERENCES: 1. US Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations. May 9, 2019. Accessed October 23, 2020. https://www.hhs.gov/sites/default/files/pmtf-final-report-2019-05-23.pdf 2. Ondrejkovicova A, Petrovics G, Svitkova K, Balogh V. Is non-pharmacological treatment an effective option for chronic low back pain? Neuro Endocrinol Lett. 2017;38(3):169-172. 3. Qaseem A, Wilt TJ, McLean RM, Forciea MA; for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a Clinical Practice Guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. 4. Derry S, Wiffen Pj, Kalso EA, et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017;5(5):CD008609. 5. Lacerenza MR, Schoss F, Grazzi L. The multimodal treatment in headaches. J Headache Pain. 2015;16(Suppl 1):A47. 6. National Institute of Neurological Disorders and Stroke. Headache: hope through research. Accessed October 23, 2020. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research#3138_2. April 2016 7. Mayo Clinic. Tension-type headaches: self-care measures for relief. Updated August 21, 2020. Accessed October 23, 2020. http://www.mayoclinic.org/diseases-conditions/tension-headache/in-depth/headaches/art-20047631?pg=2 8. Cleveland Clinic. Relaxation and other alternative approaches for managing headaches. Reviewed December 28, 2012. Accessed October 23, 2020. http://my.clevelandclinic.org/health/articles/relaxation-and-other-alternative-approaches-for-managing-headaches 9. Brander V. Changing the treatment paradigm: moving to multimodal and integrated osteoarthritis disease management. J Fam Pract. 2011;60(11, Suppl 2):S41-S47. 10. Bradley JD, Brandt KD, Katz BP, Kalasinski LA, Ryan SI. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992;19(12):1950-1954. 11. Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52(7):2026-2032. 12. Penninx BWJH, Messier SP, Rejeski WJ, et al. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161(19):2309-2316. 13. Shuchang H, Mingwei H, Hongxiao J, et al. Emotional and neurobehavioural status in chronic pain patients. Pain Res Manag. 2011;16(1):41-43. doi:10.1155/2011/825636 14. Nadler SF. Nonpharmacologic management of pain. J Am Osteopath Assoc. 2004;104(11 suppl 8):S6-S12. 15. Catella-Lawson F, Reilly MP, Kapoor SC, et al. Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med. 2001;345(25):1809-1817. 16. Hoftiezer JW, O’Laughlin JC, Ivey KJ. Effects of 24 hours of aspirin, bufferin, paracetamol and placebo on normal human gastroduodenal mucosa. Gut. 1982;23(8):692-697. 17. Blot WJ, McLaughlin JK. Over the counter non-steroidal anti-inflammatory drugs and risk of gastrointestinal bleeding. J Epidemiol Biostat. 2000;5(2):137-142. 18. US National Library of Medicine. Naproxen. Revised July 15, 2016. Accessed October 23, 2020. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a681029.html 19. Frech EJ, Go MF. Treatment and chemoprevention of NSAID-associated gastrointestinal complications. Ther Clin Risk Manag. 2009;5(1):65-73. 20. Henrich WL, Agodoa LE, Barrett B, et al. Analgesics and the kidney: summary and recommendations to the Scientific Advisory Board of the National Kidney Foundation from an Ad Hoc Committee of the National Kidney Foundation. Am J Kidney Dis. 1996;27(1):162-165. 21. US Food and Drug Administration. FDA strengthens warning of heart attack and stroke risk for non-steroidal antiinflammatory drugs. Reviewed June 9, 2016. Accessed October 23, 2020. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm453610.htm