Pain Management Case Study

I did receive a significant amount of records from this patient's PCP, as well as neurology consult in followup and infectious disease notes. In short, he is a 67-year-old right-handed white male who while living in Alaska developed some hip pain, as well as medial right hand numbness. He did have an EMG on 10/2000 that showed ulnar neuropathy with cubital tunnel syndrome on the right. Ulnar nerve transposition was considered, but the patient deferred this. He did have an MRI of the cervical spine, which revealed most significantly C3-4, moderate bilateral neuroforaminal narrowing, C4-5 severe left and moderate right neuroforaminal narrowing, C5-6 severe bilateral neuroforaminal narrowing. He did

Summary: At the Mayo Clinic, researchers are doing an electrical stimulation on the spinal cord to help a patient whose legs are paralyzed. The electrical stimulation and intense physical therapy are what the researchers believe will help the patient stand again after three years of being paralyzed. Jered Chinnock is the patient and he injured his spinal cord at the sixth thoracic vertebrae. He could not move or feel anything lower than the middle of his back. Chinnock went through 22 weeks of therapy with three training sessions per week. This was to help him prepare his muscles to move again, so that they will be strong enough to handle the physical task of the spinal cord stimulation. After the 22-weeks therapy, it was time for the team

The most relevant findings from the objective exam lead me to diagnosis the patient with a left sided C5 disc pathology causing secondary radiculopathy symptoms. Nerve roots should normally be able to withstand relative mechanical insults such as compression and stretching.4 Nerve roots can become injured in a multitude of ways including decreased space in the intervertebral foramina or spinal canal secondary to osteophytes or other degenerative changes from nearby structures such as facets or uncovertebral joints which can cause compression on the nerve root in “closing” type movements4. Other methods include herniated discs, synovial cysts or alterations in the chemical environment around the disc.5 Damage to the nerve root can cause sensitivity changes, hyporeflexia and motor weakness in the segment supplied by that specific nerve root. In this patient’s case the C5 nerve root was most indicated because it supplies the anterior shoulder dermatome, motor strength for shoulder abduction and biceps reflex. I believe the peripheralization of the patient’s symptoms laterally down the left shoulder and upper arm is caused by an increase in mechanosensitivity in which “pressure and/or stretch on a nerve produces immediate symptoms.6” When the patient decreases space and potentially compresses the nerves ie., cervical extension, lateral flexion to the left side and rotation to the left side his symptoms are peripheralized and the pain increases. The pain generators at the nerve root with increased sensitivity to these closing movements are referred to as

Per the medical report dated 08/25/16, the patient reports that her condition is unchanged. She has tried rest, heat, ice, therapy, medications, injections, splint and surgery. Patient still reports weakness, stiffness, numbness/tingling, catching and clicking. Symptoms are severe. Symptoms are made better by heat and ice, and worse with overhead activities, reaching, throwing, lifting, typing, and gripping/grasping.

Larry, a 35-year-old truck driver complained about inflammation and pain in the flexor and pronator muscles of the forearm where the tendons originate on the medial epicondyle of the hummus (by the elbow joint). The pain is penetrating the forearm in his dominant hand which is making it very hard to work because he is finding it very difficult to shift gears. He was prescribed a non-steroid anti-inflammatory and put on light duty.

could make many clients fearful of massage therapy. The therapist and the client both being involved but the therapist at fault.

The nerve did not likely have a complete laceration, but rather her post-surgical issues may have been a result of a stretching injury or adjacent soft tissue swelling which could resolve

Charcot’s Joint (neuropathic arthropathy) most often occurs in the foot and happens when a joint breaks down. In most cases of Charcot’s Joint the foot loses most of its sensation and the muscles lose their ability to support the joint completely. The foot becomes unstable and walking becomes difficult. Cranial neuropathy affect the cranial nerves that control sight, eye movement, hearing and taste. It begins with pain near the affected eye and eventually the eye muscle becomes paralyzed leading to double vision. This usually gets better after a few months. Compression mononeuropathy, a common type of neuropathy, occurs when one nerve is damaged. People with diabetes are further predisposed to compression injuries. Carpal tunnel syndrome

Few ailments prove more debilitating than chronic pain, but chiropractic care and acupuncture can provide significant relief. Dr. Randall Fick, D.C.—founder of Fick Chiropractic Centers in the Cincinnati, OH area—offers combination therapy aimed at producing quick and long-lasting results.

I was recently treated in Bahrain to twice repair a root canal followed by a molar extraction. This was carried out with nothing more than Novocaine. Needless to say, it was extremely painful and discussed with the dentist why am I not being fully sedated or given strong pain medications. He stated that sedations carry risk and intoxicants could lead to addiction. He is correct in both statements but looking back, the pain did not outweigh the

Kate is a wife and mother, as well as a rising professional. Katie is a female, age 35. Katie is currently addicted to prescription drugs; more exact pain medications and muscle relaxers. The history of abuse started when Katie was suffering from lower back pain after she had experienced an automobile accident in her mid-20’s. She took the prescribed medication as directed. During that time she discovered just how great it made her feel. “Over the next several years there were times she had reason to visit her doctor about one thing or the other and usually was able to walk out of the doctor's office with a prescription for some pain pills.” (Case Study 3)

Analgesics: NSAIDS, Opioids - Can be administered PO or parenterally - Side effects incl. constipation - Danger of infection Thermal application: Heat/cold - Heat: Reduces pain, Increases healing - Cold: Reduces swelling, promotes numbing - Thermal application applies comfort. - Too hot for patient, risks of burning - Too cold for patient, risks of frostbite Massage - Reduce inflammation - Reduce fluid buildup - Reduce muscle tension and promote comfort - Distraction from pain - Invasive -

I have set him up for EMG nerve conduction studies. Luckily, the treatment of human immunodeficiency virus polyneuropathy does require good control of the human immunodeficiency virus infection and he has not yet started his antivirals. Hopefully, when he does, that will help with his symptoms. I also think that we need to take a good look at that lesion he has in his conus. Certainly, it could be infectious and I defer to infectious disease to decide whether or not a needle biopsy is required. He is not demonstrating any signs of a

Joshi, G., & Kehlet, H. (2013). Procedure-specific Pain Management: The Road to Improve Postsurgical Pain Management?. Anesthesiology, 118(4), 780-782.

For patients, there are many safe options to help with pain and the process of healing. Users can choose between a number of pain therapy options that fits their needs. When choosing an item to help with pain management, users should consider these things...