Arthritis—same as treating most other pain - large amounts of paractamol, ibuprofen (and other nsaids) and diclofenac gel is what we do for arthritis.
I’m the opposite of an expert on migraines, and it looks like I’m technically just wrong. They are super common even in low income countries in the medical literature. After being here for 9 years I think I’ve only clearly diagnosed a migraine twice after seeing many thousands of patients. Maybe many with headaches (that we give ibuprofen to) might technically qualify as migraines but we just diagnose as tension headache. The migraine diagnosis is hardly made by anyone here.
Even with that I’m super dubious about that global burden of disease study which puts Migraine Dalys that nsanely high, but I don’t know enough to specifically criticise.
What this means is that there would be multiple barriers to working on migraines—poor understanding by local clinicians (like me), teaching about correct treatment, then availability. Seems tricky and obviously local doctors here don’t see it as a priority
Hi Nick,
A quick comment to thank you for engaging with our work and for your insights. This is super interesting.
Arthritis—same as treating most other pain - large amounts of paractamol, ibuprofen (and other nsaids) and diclofenac gel is what we do for arthritis.
This suggests that this could be really cost-effective, considering the price of NSAIDs! However, wouldn’t issues of side effects also occur here? Or is this less of an issue because the gains would be higher?
Side effects issue is also there, but like I said it’s more a thing to be aware of, that the intervention can’t be too just spray ibuprofen into the masses (like is often done with malaria medication, ORS for diarrhoea etc.) because there is a relatively common, dangerous side effect. If it’s given after asking the right questions and with good advice, it’s no problem at all—in high income countries. we give out relatively large amounts of NSAIDs without being overly concerned
Preventing the side effects issue is more about good administration, and medications being given after good history taking and diagnosis by a clinician. In high income countries we have no qualms about giving l large amounts of nsaids, as long as we aren’t giving them to people with gastritis, people are taking them with water and food and People understand what symptoms to look for to stop.
It just means it’s a bad idea up have noon qualified prior giving them out like lollies, which does happen a lot. In many western countries nsaids are sold at supermarkets, which shows you it’s not a game changing problem, just one to be careful about.
Can always reach out to me!
Arthritis—same as treating most other pain - large amounts of paractamol, ibuprofen (and other nsaids) and diclofenac gel is what we do for arthritis.
I’m the opposite of an expert on migraines, and it looks like I’m technically just wrong. They are super common even in low income countries in the medical literature. After being here for 9 years I think I’ve only clearly diagnosed a migraine twice after seeing many thousands of patients. Maybe many with headaches (that we give ibuprofen to) might technically qualify as migraines but we just diagnose as tension headache. The migraine diagnosis is hardly made by anyone here.
Even with that I’m super dubious about that global burden of disease study which puts Migraine Dalys that nsanely high, but I don’t know enough to specifically criticise.
What this means is that there would be multiple barriers to working on migraines—poor understanding by local clinicians (like me), teaching about correct treatment, then availability. Seems tricky and obviously local doctors here don’t see it as a priority
Hi Nick, A quick comment to thank you for engaging with our work and for your insights. This is super interesting.
This suggests that this could be really cost-effective, considering the price of NSAIDs! However, wouldn’t issues of side effects also occur here? Or is this less of an issue because the gains would be higher?
Thanks Sam
Side effects issue is also there, but like I said it’s more a thing to be aware of, that the intervention can’t be too just spray ibuprofen into the masses (like is often done with malaria medication, ORS for diarrhoea etc.) because there is a relatively common, dangerous side effect. If it’s given after asking the right questions and with good advice, it’s no problem at all—in high income countries. we give out relatively large amounts of NSAIDs without being overly concerned
Preventing the side effects issue is more about good administration, and medications being given after good history taking and diagnosis by a clinician. In high income countries we have no qualms about giving l large amounts of nsaids, as long as we aren’t giving them to people with gastritis, people are taking them with water and food and People understand what symptoms to look for to stop.
It just means it’s a bad idea up have noon qualified prior giving them out like lollies, which does happen a lot. In many western countries nsaids are sold at supermarkets, which shows you it’s not a game changing problem, just one to be careful about.