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CHRONIC BACK PAIN
Chronic back pain is identified as a common problem in healthcare which calls for the careful examination to identify the particular type of back pain. These types include back pain due to the spinal cause, due to the nonspinal source, nonspecific low back pain, and spinal stenosis. Evaluation of the patient experiencing chronic pain is necessary so as to commence the appropriate treatment to manage the situation (Buttaro et al, 2013).
The evaluation of chronic of back pain entails the physical and history examination of the patient. There are various factors that I would put into consideration while carrying out the assessment. Differential diagnosis includes evaluation for congenital disease, lumbar strain, the traumatic fracture and presumed instability (Buttaro et al, 2013).The description of how the pain started and also the intensity, duration or pattern of the pain by the patient would help in evaluating the symptoms and sites of pain.
Assessment of the chronic back pain related symptoms such as numbness, weakness, or bladder problems is essential in the evaluation. Previous episodes of back pain and the type of treatment adopted are essential in tracing the history and the experiences of the patient and the effectiveness of the management strategies used.
The working history about the patient is important so as to get a link between the back pain and work. Assessment of the sensory and muscular problems would be performed through a series of movements performed by the patient (Buttaro et al, 2013). The assessment factors would help in the evaluation of the patient who presents with chronic back pain.
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There are various warning signs that indicate that the patient is abusing the drugs prescribed by the healthcare profession. Finishing the prescription earlier than recommended raises a red flag that treatment schedule has not been properly followed (Buttaro et al, 2013). Requesting for specific dosages and medication is an indicator of poor pain management. Borrowing of medication from other people is a warning sign of abusing medication. Using medication prescribed for others or stealing drugs raises a red flag.
Losing the prescription provided as medication for pain management is a warning sign of drug abuse. In cases where the patient rates pain as ten on a numerical scale. Such rates create suspicion of whether the prescription is of help to the patient or is abused so as to get more falsely. Visiting the emergency rooms without the conscience of the doctor so as to get additional medication raises a red flag (Buttaro et al, 2013).
There are several implications that should be considered when giving prescriptions for narcotic pain. Ethical implications arise when the providers prescribe narcotic drugs as per their self-serving reasons or to have some financial gain (Buttaro et al, 2013). The drug-seeking reasons that are illegitimate in nature can lead to an ethical implication when the medication is provided to the patient. The providers have high pressure to prescribe controlled substances such as narcotics. In this case, the providers are faced with the dilemma of whether to serve the patients as per their interests or to do what is indicated as ethically appropriate.
Narcotic dependence and addiction by the patient make it cumbersome for the care provider to prescribe the medication as per clinical standards (Buttaro et al, 2013). Considering the modified treatment strategies e.g. deep tissue massage to manage pain instead using narcotic that pose some problems in making clinical decisions resulting to ethical implications is crucial during treatment (Buttaro et al, 2013). Due to the arising ethical implications, health professionals should advocate the use of narcotics as indicated medically.
Reference
Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.
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