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Health assessment
Whereas adequate pain control is every patient’s fundamental rights, it is important to ensure that pain management medications are not abused. The health care providers ae challenged in dealing with these ethical scenarios of deciding the way to go in pain control versus the risk of abuse and misuse of prescribed medication.
In this context, the healthcare providers must perform health assessment adequately in order to identify the root cause of the chronic pain. Managing the causes of the chronic pain will simultaneously address the pain and consequently, reduce the incidences of potential abuse of narcotics (Wand, O’Connell, Di Pietro & Bulsara, 2011).
In this context, initial evaluation includes physical examination and patient history. The health assessment will help the healthcare provider identify red flags and warning signs of prescription abuse/ narcotics addiction. These include signs such as anxiety, depression, as well as the pain syndromes. Other signs include manipulative attitude and aberrant behaviour such as requesting refills frequently or experiencing withdrawal syndrome (Manchikanti, 2010).
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This helps in categorization of the chronic back pain as a) non-specific back pain; b) back pain associated with spinal stenosis of radiculopathy; c) back pain originating from the non-spinal source and d) back pain due to specific spinal source. For patients whose back pain is categorised as due to radiculopathy, specific spinal source or spinal stenosis; they should undergo Magnetic resonance imaging (MRI) as well as the Computed tomography (CT) to establish the exact diagnosis or the exact cause of the disease; which will facilitate in guiding the specific care plan (Wand, O’Connell, Di Pietro & Bulsara, 2011).
Other evaluations include laboratory assessment which should include complete blood count (CBC), erythrocyte sedimentation rates, and the level of C-reactive protein level. Urinalysis can also be performed to identify suspected infections as well other macronutrients levels such as alkaline phosphatase and the calcium levels. The laboratory findings can help diagnose the root cause of the infection.
For acute low back pain, they should be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. I will also encourage non therapeutic interventions such as healthy diets, exercising, behavioural therapy and psychiatry sessions. This will help managing the chronic pain holistically (Manchikanti, 2010).
References
Manchikanti, L. (2010). Evaluation of Lumbar Facet Joint Nerve Blocks in Managing Chronic Low Back Pain: A Randomized, Double-Blind, Controlled Trial with a 2-Year Follow-Up. International Journal Of Medical Sciences, 124. http://dx.doi.org/10.7150/ijms.7.124
Wand, B., O’Connell, N., Di Pietro, F., & Bulsara, M. (2011). Managing Chronic Nonspecific Low Back Pain With a Sensorimotor Retraining Approach: Exploratory Multiple-Baseline Study of 3 Participants. Physical Therapy, 91(4), 535-546. http://dx.doi.org/10.2522/ptj.20100150
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