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- Nursing Staff, Patient, and Environmental Factors Associated with Accurate Pain Assessment - 2010-09-07
- Do Sex Differences Exist in Opioid Analgesia? A systematic review and Meta-Analysis of Human Experimental and Clinical Studies - 2010-09-07
- The Psychometric Qualities of Four Observational Pain Tools (OPTs) for the Assessment of Pain in Elderly People with Osteoarthritic Pain - 2010-09-06
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The Emerging Solutions in Pain Case Library is a resource that illustrates assessment, diagnosis, management, monitoring, and special considerations including tools and tips for managing chronic pain patients. Click on the manila folder tabs to reveal relevant content. A new case will be added monthly. Last Updated Friday, July 9, 2010
Mark is a 42-year-old radiographer who presents with a chief complaint of acute low back pain, with pain radiating to the right leg. He has a 10-year history of degenerative disc disease, characterized by 1 to 2 episodes of low back pain per year, however, these events typically resolve in response to rest and with prescribed use of a methylprednisolone dose pack.
His past medical history indicates tobacco use of 1/2 pack per day for 5 years and occasional alcohol use, reportedly 3-4 drinks on weekends only. A brief family history indicated that his father was a recovering alcoholic and his mother was diagnosed with generalized anxiety disorder. Mark denied personal history of illicit substance use, and reported no history of depression or anxiety.
Mark’s current condition began at work while he was transferring a patient from the gurney to bed. As he bent down to move the patient, he experienced severe pain in his lower back which radiated downward, affecting his right leg. He was seen in the emergency department, but his radiographs were read as ‘negative,’ and he was discharged with a prescription for cyclobenzaprine (10 milligrams) and ibuprofen (800 milligrams), both of which were to be taken three times a day. Mark’s leg pain worsened over the next two days. As a result, he was unable to return to work and after several months was referred to the hospital’s occupational medicine clinic.