Mr Fountain Case Summary

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

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.

A judge in Upstate New York dodged the boot after he was charged of more than two instances of judicial misconduct. A counsel for the state Commission on Judicial conduct recommended Hastings Town Justice Michael R. Clark to be removed from the bench two years ago. Last week its 11-member panel unanimously ruled to punish the judge for a variety of misconduct in 2010 and 2011.The commission ruled Clark dismissed or reduced certain charges without giving information to the prosecution, did not provide a defendant with the opportunity to speak on bail. Clark also forced conditions of release with no legal basis and made inappropriate comments about the defendant’s appearance.

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.

Per the medical report dated 07/21/16, the patient has benefited from low-dose Vicodin 5/300mg to the extent that it reduces her pain levels from 8 to 9 out of 10 down to 3/10. Her toxicology screen is consistent with the medicine she is taking. There is no evidence of abuse and she is having no side effects from the medicines. She also remains on Zoloft 200mg at night and Restoril 30mg at night for insomnia. On mental status examination, her mood is less depressed with the use of Zoloft. Per treatment plan, the patient is doing well on her current medicines. They have increased her energy, decreased her depression, and provided significant effect on the pain that she suffers without side effects.

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,

Per office visit notes dated 8/7/2016, patient presents for a follow up for neck pain, left elbow pain and bilateral wrist pain. Current medications include Naprosyn EC 500 mg, Tramadol 50 mg, Lyrica 50 mg and Levora-28 0.15/0.03 mg. Patient was recommended retrial of Celexa for her depressed mood related to her chronic

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

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

Based on the medical report dated 01/20/16, the patient reports that his low back pain is rated as 9/10 into the right lower extremity. It’s experienced between 76% and all of the time he is awake. Some of the patient’s daily activities are being prevented by this symptom. He reports numbness and tingling in his right lower extremity.

On admission, Ms. Kelly complained of low back pain ranging in intensity from 7 to 8, out of 10, on the pain scale where 0 is no pain and 10 is the worst imaginable pain. She subjectively describes this pain as throbbing, stabbing, burning and radiating down into both legs, left worse than right. In addition, she has sharp, stabbing, burning pain in both her arms, left worse than right, and experiences intermittent tingling and numbness sensations in both her hands. She has pain in her neck and shoulder that she defines as tension-type pain. Factors that can aggravate the pain include

She presents with severe episodes of back pain and sometime extension in the lower extremity .Her problem started when she fell off a horse when she was 10 or 11 age . This pain aggravate during movement and walking . Additional she complains of often epigastric pain , probably combined with intake of different food components.

He described the pain as a constant, dull achy sensation that was aggravated by prolonged walking, bending forward or backward at the waist and by squatting. He states his pain level was decreased with medications. He reported that Voltaren ge works better for him than any of the oral medications. He also has completed 3 sessions of acupuncture and has 3 more remaining. The patient reported that his lower back pain was decreased with acupuncture. He continued to wear a double back lumbar support as directed. His examination revealed tenderness to palpation over the midline lumbar spinous processes and paravertebral muscles bilaterally. There was a decreased active range of motion with pain at 40 degrees of flexion, 10 degrees of extension and at the limits of full right and left lateral bending and rotation. The patient can perform 50% of the normal squat but complained of increased pain as he returned to an upright position. The neurovascular status was intact for the lower extremities. The treatment plan included additional acupuncture

As per medical report dated 3/10/2016, patient complains of low back pain rated at 7/10 with left lower

Because patient selection for surgery can be quite challenging and narcotic intake is at its high, interventional pain management is a great alternative for pain relief. With the use of fluoroscopic guidance, a physician can diagnose and treat a problem that a patient may be having. Determining whether the patient’s pain is radicular or somatic is the first key to creating an appropriate treatment plan as shown in figure 1 (J. Iannucccili, E. Prince, & G. Soares, 2013, p. 308). The treatment plan must consider the procedure needed, the techniques used per procedure, and the efficacy of each procedure. This article will review each topic for the most common back pain