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Celebrex Case

Satisfactory Essays

This is a 54-year-old male with a 1/17/2012 date of injury. A specific mechanism of injury has not been described.

01/04/15 Pain Management Report indicated that the patient has a right middle trigger finger and left knee pain. He is requesting injection for it. It is achy and occasionally stabbing. The pain is aggravated by prolonged sitting and sitting. There is associated crepitus. He is requesting an injection. Previous treatment included PT, bracing, taping and anti-inflammatory medications. He also has right foot arthritis and was given Celebrex for that. Lidoderm either on the neck, lower back or left knee has no side effects. It reduces intensity of pain to a more dull sensation. It numbs the area and provides a sense of improved …show more content…

It is noted that Celebrex aids in reducing arthralgia and reduces frequency and severity of flare-ups. However, there is no documentation of why a non-selective Cox inhibitor is not appropriate for this patient. Furthermore, there is no documentation of increased risk for gastric complications or prior gastric conditions. Failure of first line NSAIDs was not described. Medical necessity of Celebrex has not been substantiated. Therefore, recommend …show more content…

This is not a first-line treatment and is only FDA approved for post-herpetic neuralgia. The patient complains of neuropathic pain. He has been using Lidoderm patches for pain control for an extended period of time. The exact duration of use is unknown but it is noted in the QME report that the patient was taking it before Lyrica had been prescribed. There is reported pain relief and functional improvement form the medication use. However, the patient is already taking the first-line drug Lyrica for neuropathic pain. It is unclear, why a concomitant second-line drug is indicated at this time. Furthermore, the patient has neck pain, lower back pain and knee pain; it is unclear, for which area Lidoderm is being requested. Medical necessity has not been established. Recommend

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