Mr Fountain Case Summary

Ms. Kelly is a nondrinker, smokes five cigarettes per day and uses recreational grade cannabis for pain and sleep daily.

As per progress report on 5/24/16, the patient is still having a lot of low back pain that radiates to his lower extremities. He continues to find his

Search strategies for this review will be established to access both published and unpublished materials. Firstly, a search of the literatures will be conducted using numerous online databases. Similarly, a range of research methods that assist in finding appropriate journal articles will be utilised. These include consideration about which topics that most define chronic low back pain management and different interventions used for management of this condition. Further, to ensure whether the study is appropriate and relevant to the research question, both an inclusion and exclusion criteria will be considered. Thus, articles will be included if they meet the following principles: published between 2002 and 2016, articles related to nursing and health professionals, and written in the English language and Peer-reviewed articles as well.

Pregabalin is an antiepileptic agent, which acts by reducing calcium inpouring in neuronal cells. As a results, this decrease the release of some neurotransmitters involved in pain processing (Mease, 2011). Pregabalin is one of the most effective drugs to treat fibromyalgia. However, there are many side effects associated with it. These side effects are drowsiness, dizziness, dry mouth, constipation, difficulty concentrating, swollen arms, and legs (Mease, 2011). Duloxotine is also used to treat fibromyalgia. It is SNRI, serotonin- norepinephrine reuptake inhibitor. This medication acts by inhibiting the reuptake of serotonin and norepinephrine, which modulates the sesation of pain (Mease, 2011). Milnacipran a SNRI, acts in the same way. Some side effects of Duloxotine and Milnacipran are nausea vomiting, dizziness, drowsiness, headaches, hot flashes, and weight changes (Mease, 2011). Nevertheless, the side effects of these drugs. These drugs have had documented success in the treatment of fibromyalgia. As a matter of fact, a 12-month study conducted by researchers, showed the responses of a research group to Pregabalin, Duloxotine, and Milnacipran. Overall, Pregabalin was the most successful in the treatment of fibromyalgia. Overall, the study revealed that over a 12-month period 50% of the research group have had a significant reduction in pain, while

The client was administered the Minnesota Multiphasic Personality Inventory- 2nd Edition-Restructured Form (MMPI-2-RF) as an objective measure of their social-emotional and personality functioning. The scores are based on answers to a large number of true/false questions. Based on Mr. Cintron’s responses, this protocol was invalid and uninterpretable due to inconsistent responding. There was evidence of excessive inconsistency because of fixed true responding to the test item.

Robert Trinh is a 34 year-old senior truck driver referred to your outpatient physical therapy office for “chronic low back pain” which started 7 months ago. He was lifting a particularly heavy load that day and felt something “tweaked” in his low back as he was bent over and moving the load from the truck into the sidewalk. He remembered being in a bent over posture and cannot straighten up for about 2 weeks and the posture gradually resolved. Current pain level is 8/10 with sharp burning sensation in the low back (P1= symptom location #1) that radiates down to the posterolateral right lower leg (P2= symptom location #2). The entire right lower leg also feels tingling often. Robert reports that the right lower leg can feel very sensitive at

On January 4, 2011, Ms. Carey presented to Florida Rehabilitation and Injury Center with complaints of upper back and mid back pain. Ms. Carey described the constant sharp, dull and aching pain as a 5 on a scale of 1 to 10. Ms. Carey underwent physical therapy, hot pack therapy and electrical muscle stimulation.

Low back pain (LBP) is one of the leading causes of disability and work absence globally, affecting not just the individual, but also extending to families, communities and society at large. Whilst the prevalence of LBP is high, with over 70 percent of people experiencing some LBP at some point during their lives, most will resolve within a few months (Campbell et al, 2013). Problems arise when pain persists beyond the expected period of healing or when it exceeds 12 weeks in duration. An estimated 40 percent of people who present with acute LBP continue to report symptoms after 3 months and

Back pain is one of the most commonly reported health problems among working adults. One of the primary reasons

Volunteer denies any medical or surgical history except for the allergies. He says that his mother had high blood pressure from the age of 48. He is seeking physical therapy for the low back pain which he has been experiencing since 12/08/2015. According to him, he started to experience pain after he had bent from the chair to pick up his books lying on the floor. He complains that he have had episodes of low back pain in past which had gone away with rest within a week. He is having bed rest and some Advil for the back pain, but denies of taking any other prescription medicines. He reports that, activities such as bending, standing for long worsened the pain. In addition,

It was found that subjects on duloxetine showed significant improvements in I-QOL scores and significant decrease in IEF compared with the placebo subjects. It was also noted that 87% of patients on the placebo completed the study compared to the 69% of subjects on duloxetine. This difference can be attributed to a higher rate of duloxetine discontinuation due to side effects. Nausea was the most common side effect reported in 91% of participants, however, 81% reported resolution within 1 month. Serious adverse effects were rare and not significantly more common in the duloxetine

02/09/16 Progress Report noted that the patient’s current medication regimen provides moderate pain relief without any adverse effects. The patient stated that he has seen Dr. Smith for IT pump clearance and would like to proceed with the trial. He has chronic lumbar back pain. The pain radiates the left buttock, left posterior thigh, left lateral thigh, left lower leg, left foot, and right lateral thigh. The patient describes the pain as sharp, dull, aching, bumping, stinging, and throbbing. The onset was sudden immediately after the injury. The symptoms are constant and the episodes occur daily. The symptoms are described as severe and worsening. Back motion, lifting, and bending exacerbate the symptoms. Associated symptoms include leg numbness, foot numbness, leg weakness, and foot weakness. Current treatment includes opioid

So, what did I do when I got that crazy advice from my doctor? I blew it off obviously, because it was nonsense… and then I set out to find the real answer to my lower back pain, using scientific research and medical studies.

As per medical report dated 2/18/16, patient complains of constant low back pain in a L4-5 distribution. Patient has undergone physical therapy as well as medication management without amelioration of the pain and continues to be symptomatic. He had previous epidural steroid injection. He also had acupuncture

. In addition, per guidelines, duloxetine (Cymbalta®) is FDA-approved and also used off-label for neuropathic pain and radiculopathy. There was also an FDA panel concluded that duloxetine was effective in treating chronic low back pain. In addition to that FDA notes that the degree of pain relief may have been greater in those with comorbid depression. Therefore, the request of 60 Capsules of Prevacid Delayed Release 30mg and 120 Capsules of Duloxetine 60 mg is medically