The painkiller ibuprofen-found in over-the-counter Advil and Motrin—works better at relieving children's pain from musculoskeletal injuries such as sprained ankles than other drugs commonly used in hospital emergency departments, according to a new study.

In fact, a standard non-prescription dose of ibuprofen brought better relief-at least in the minds of patients—than a prescription dose of codeine, reports study head Dr. Eric Clark, an emergency medicine specialist at the University of Ottawa School of Medicine. Ibuprofen was also tested against acetaminophen, the active ingredient in Tylenol.

"No one had done comparison studies on the pain medications we use son children)," says Clark. "Some of us were already using ibuprofen more than the others, and I think this study just confirms our clinical experience."

The Study

His study tracked 300 children, ages 6 to 17, who were brought to the emergency department of the Children's Hospital of Eastern Ontario with a musculoskeletal injury to their extremities, neck or back. Each child was asked to rate their pain level, from "no pain" to "the worst pain they have ever felt."

Clark's team randomly assigned the children to one of the three treatment groups. The children, parents and research assistants who asked them about pain did not know which medication each child received. Each was given a standard dose orally, prescribed by the child's weight.

After the children took the medicine, they were asked to describe the pain every 30 minutes for two hours, using the same description as before.

"The primary outcome we were looking at] was at one hour," Clark says. At the one-hour mark, the ibuprofen group had better pain relief. Those given ibuprofen were least likely to ask for more medicine for pain relief after an hour, he adds.

The Reaction

Clark's results come as a surprise to some doctors. "I would have guessed codeine" would bring better relief, notes Dr. Dennis Woo, of Santa Monica-UCLA and Orthopaedic Hospital in California.

Indeed, codeine, a more powerful drug, has a reputation of being more effective against acute pain.

Still, Woo says that Clark's study is good news. He personally tries to avoid giving codeine for kids' pain management because it spaces them out," he says.

Bottom line for parents: "When we send parents home with children with bumps, bruises and broken bones, we suggest parents use ibuprofen as well," says Clark. The same applies for treating musculoskeletal injuries not severe enough to seek medical care.

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