Patient presents to the Emergency Department with an acute, soft tissue ankle or forearm 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
You may not be if
Patient is diagnosed with a fracture
Patient has an allergy to ibuprofen
Patient is already on a NSAID, acetaminophen, anticoagulant or oral corticosteroid therapy for chronic pain treatment (a NSAID given in triage or use for the current injury 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 or metabolic 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
Clareo Health | Arnica and the Management of Pain in Acute Musculoskeletal Extremity Injuries
