Low back pain is one of the most common complaint seen in the hospital. The purpose of this review is to identify the recent advances in the management of low back pain. This review shows diagnostic studies, pharmacological, interventional, surgical, and non-pharmacological management of low back pain. Many patients with low back pain receive routine imaging for the spins which include lumber radiology, computed tomography (CT), and magnetic resonance imaging (MRI). According to the American College of Physicians(ACP), and American Pain Society (APS) recommendations, the routine imaging dose not result in any clinical improvement or benefits. Furthermore, the imaging is only recommended for patients who are with sever progressive neurological …show more content…
They found out that there were no difference in pain, function, and quality of life between the patients who received a routine imaging such as CT and MRI, and the patients who were received only the routine care without imaging (Chou, 2011). To manage low back pain medications are commonly used to manage low back pain. Paracetamol and Non Steroidal Anti-inflammatory Drugs (NSAIDs) are recommended as the first line of medications. However, there is no strong evidence that support the use of paracetamol and the NSAIDs are not recommended for elderly patients with gastrointestinal, cardiovascular and renal comorbidity (Morlion, B., 2013). Another type of medications is opioids but they should be used with caution. They have many adverse events, and causes abuse with long-term use. The benefits should outweighs the risks to be used for chronic low back pain management for a longtime (Morlion, B., …show more content…
Also, anticonvulsants show an effect when combined with opioids and muscle relaxants are more effective with acute low back pain than chronic (Morlion, B., 2013). Managing low back pain is not confined to medications, there is also interventional techniques including epidural steroids injections and facet joint interventions. Facet joint intervention “ involves percutaneous placement of radiofrequency electrode on the lumbar medial branches to deliver an electric current to coagulate sensory nerves”. Furthermore, surgery can be an option as with spinal decompression, spinal fusion or disc arthroplasty (Morlion, B.,
Patient denies any complications and new complaints associated with epidural steroid injection procedure; however, he states that approximately 5 days after the injection procedure, he felt a sharp shooting pain down the posterior aspect of both legs to the feet to the feet when lying on his back with his feet on the floor. Otherwise, he reports ongoing axial lower back pain and weakness with no significant radicular symptoms at this time. He reports only mild relief with use of over-the-counter ibuprofen. In addition, he reports of moderate pain located at the low back which describes as an aching, continuous and sharp pain. He rated his pain as 5/10 in severity at the time of visit.
Page’s patient, P, suffers from back pain and he is determined to find the cause of the pain. To rule of the most lethal causes of back pain, some of the questions Page asks include “Did the pain wake him up at night? Was it worse when he was lying down? Had he recently lost weight?” (Page).
A lot of this pain is unnecessary. A visit to an experienced chiropractic physician like those at Stroud Chiropractic could help alleviate this pain. Stroud Chiropractic- October Generally chiropractic physicians treat pain without drugs. With Stroud Chiropractic you can expect skillful health professionals to use the
10/28/15 progress report described that the patient has pain with positive bilateral lumbar facet loading. The patient also complained of unprovoked occasional back spasms. There was little or no improvement in sleep and pain from Trazodone and Tramadol, so the patient had been prescribed Valium 5 mg, Mortin 600 mg, and Cyclobenzaprine. 10/28/15 progress report noted that the Valium was prescribed for insomnia. However, 11/26/15 note states an appeal to the denial of Valium and noted that it was being prescribed to address the muscle spams.
Range of motion was restricted inflexion and extension due to pain. Patient was diagnosed with impaired vision, cervical spine sprain/strain/herniated cervical discs, lumbar spine sprain/strain/herniated lumbar disc at L4-5 and L5-S1, right shoulder sprain, right elbow sprain and right hand sprain/strain rule out tendonitis and carpal tunnel syndrome. Treatment plan includes to start chiropractic treatments for 2 x 5 weeks for the cervical and lumbar spine to improve range of motion, improve function and decrease pain and spasms; cervical spine ESI at C5/C6 and C6/C7 and lumbar ESI at L4-5 and L5-S1 to attempt to reduce pain, decrease medication intake and increase functional capabilities. He was given a refill prescription for topical creams, Norco 10/325 mg 1 tablet every 4-6 hours #90, Ultram extended release 150 mg 1 tablet twice daily #60, Celebrex 200 mg 1 capsule daily #30, Protonix 20 mg 1 capsule twice daily #60 and Fexmid 7.5 mg 1 tablet three times a day #120.
In the past, opioids have been used to treat moderate to severe pain such as cancer or post surgery, and on a short term basis. Now they are prescribed to anyone who is experiencing chronic pain and on a long term basis. Opioids being taken for chronic pain allows everyone to have the ability to carry out their daily life easily and without pain. In light of opioids helping people manage their pain, the problem lies with what they are being prescribed for now, how long, and how much. Opioids are now being prescribed for back pain, migraines, and other small instances.
Human beings generally always want to avoid pain. Whether it be emotional or physical, we try to find ways to relieve and/or replace discomfort with some comfort. Physicians and other healthcare professionals are faced with patients daily who want most if not all of their pain taken away. To address this concern, doctors can prescribe painkillers to help alleviate some of the pain. However, those painkillers, specifically opioids, are becoming a problem as they are being abused and people are becoming addicted to them.
Consistently outweighing those related to natural and semisynthetic opioids, synthetic opioids, methadone, and heroin (Dal Pan, 2016). On the other hand, nonopioid analgesics or NSAID’s like Naproxen or Ibuprofen tend to be the norm for treating mild to moderate nonspecific lower back pain due to anti-inflammatory properties and analgesic properties (Adams
Some patients prefer not to take pain medication because they fear addiction or may have a history of substance abuse. Educating the patients on their right to be free of pain and having their pain managed aggressively is a priority in the recovery phase. The goals that I hope to achieve during this clinical practicum
The upswing in prescriptions stems from a report in 2000 that said doctors didn’t treat patient pain properly. The report went on to recommend doctors check on patient pain at every appointment. The problem is that the only way to assess pain is to ask patients about their pain level. If a patient says he’s in terrible pain, the doctor is encouraged to prescribe something.
His doctor recommended the applicant to have acupuncture and physical therapy. He said that there has not been any discussion of surgeries or injections. He takes Naprosyn three times a week. He claims that he began having radiating pain into his knee since he started treating at Southland Spine. He claims this pain occurs three times per month.
The primary purpose of a back support or back brace depends heavily upon the person wearing it. Back braces can prevent pain or injury, reduce pain or aid in the healing of an injury or the site of a spinal operation. Lumbar supports can serve a number of different purposes as well, reducing back pain or preventing injuries in people who are required to lift heavy objects. There are several different types of supports designed specifically for the lumbar region, including the lumbosacral corset, sacroiliac belt and the lumbosacral belt. Choosing the right one is important in getting the most out of what these braces and supports are designed to accomplish.
There are many self-help treatments that may help relieve discomfort. Treatment options include exercise, rest, heat and cold therapy, massage, and acupuncture. Talk to your physiotherapist about what exercises you can do to maintain the health of your back and improve your overall health. The basic treatment for relieving back pain is rest.
The reason for the use of once-daily tramadol ER is that it results in less frequent fluctuations in plasma concentrations than the equivalent daily doses of short-acting tramadol. Moreover, tramadol is used in the management of postoperative pain. The off-label indications of tramadol include its use as an adjuvant in the treatment of arthralgia associated with osteoarthritis and treatment of postherpetic neuralgia (Clinical Pharmacology,
Pain Management and the post-surgery healing processes are a difficult area to study based on the personal nature of how each individual patient deals with and visualizes their own pain and recovery. Still, nursing researchers and practitioners are constantly looking for methods to improve or augment current pain management practices within contemporary nursing practice. In more contemporary pain management strategies, there is often a tendency to over rely on pharmaceutical medications. Pain is experienced by patients