An emergency department note dated 11/02/2017 indicated that the claimant presented with a low back pain and right hip pain. His back pain started a month ago and had been worse the past 2 weeks. He stated that pain is aggravated by sitting and slightly relieved by standing. His BMI was 31.92. A lumbar spine x-ray was ordered and medications were provided.
Three-view lumbosacral spine survey dated 11/02/2017 was unremarkable. There was no evidence of fracture, disc space narrowing, or scoliosis.
A visit note from Masahisa Amano, MD (Family Medicine), dated 11/03/2017, indicated that the claimant presented for a post ER follow-up visit with a sharp pain in the back radiating down to his right hip/leg. He stated that Ibuprofen and Cyclobenzaprine provided minimal relief. His blood pressure was 132/79. He was diagnosed with a back pain and abnormal liver function tests. A repeat of lab tests was recommended.
…show more content…
Amano, dated 11/10/2017, indicated that the claimant reported that back pain was improving with medication. Ultrasound dated 06/10/2017 revealed a fatty liver with 2 mm gallbladder polyp. Previous laboratory results dated 05/31/2017 showed GGT at 349, AST at 53, and ALT at 86. A repeat of laboratory tests dated 11/04/2017 showed an elevated GGT at 193 with normal levels of AST at 28 and ALT at 31. His BMI was 33.79. He was diagnosed with a fatty liver disease. A referral to contemporary PT was
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
This case involved a 53 year old man who sustained a significant tear of his rotator cuff while playing baseball. He underwent surgical repair and was given a referral for physical therapy. The referral was to begin passive ROM 3 times per week for 2 weeks then initiate a supervised home program of active exercise for 2 weeks, and elastic resistance exercises for internal and external rotation every other day for a month. 2 weeks after surgery, he had his first PT visit in a sports medicine clinic that was managed by an athletic trainer (ATC).”
Journal of chiropractic medicine. Volume 11, Issue 1:58-63. Papa J. 2012. The. Conservative management of lumbar compression fracture in an osteoporotic patient: a case report.
Chronic pain is a long term condition, which means it cannot be cured, but the symptoms may be controlled by therapies and medications (Saxon and Lillyman, 2011). When pain is considered chronic, it lasts longer than the expected healing period and there may not be a clear cause (Kraaimaat and Evers, 2003).
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
Tests after tests including MRI’s, X-rays, and experimental procedures were performed to show I had five ruptured disks in the lower lumbar section of my back. Tedious Examination done by a group of doctors concluded I had a crippling disease of the spinal column called spinal stenosis. Spinal stenosis is a narrowing of the spinal canal that causes compression of the spinal cord. (Lohr,1) If this disease was ignored any longer, it would lead to many other problems affecting other areas of my back to help support this weakness. It was an extremely rare case for an athlete my age.
History of present illness: The patient is a 71 year old male of the Veteran Association. His past medical history includes coronary artery disease and chronic obstructive pulmonary disease. The patient was involved in a contraindication at home where he was thrown into a dresser and hit his lower back. Shortly following the incident the police were contacted. During this time the patient consequently began to develop some substernal chest pain with a radiation to the left arm; the patient also became diaphoretic and somewhat out of breath. Emergency medical services (EMS) were contacted. EMS gave the patient aspirin and nitroglycerin and started a saline lock. EMS brought the patient to the emergency department. The patient had
Jackson, M.A. & Simpson, K. H. (2006). Chronic Back Pain. Continuing Education in Anaethesia, Critical Care and Pain, 6(4), 152-155. http://dx.doi: 10.1093/bjaceaccp/mkl029
This was his second episode since 10 days ago where he develop the same pain at his right flank. He suddenly experienced severe pain 8 hours before admission when the pain shifts to his right lower quadrant of his abdomen. The onset is at 6.30 am before worsening at 10 p.m to 2 p.m. He described the pain as continuous sharp pain and gradually increased in severity. There is no radiation of the pain. The pain was exaggerated on movement and touch. There were no relieving factor and he scale the severity as 7/10. He experienced fever for 1 day prior to admission. It was a mild grade continuous fever. He does not experienced chills and rigor. The patient does not experience any nausea or vomiting, no dysphagia, no pain during micturition and no alteration in bowel habit. He experienced loss of appetite but not notice any weight loss.
If the spine is normal then the issue is part of the child growing or a different issue that is causing enough pain to warent a trip to the doctors. If the angle is off however then it will be diagnosed as Scoliosis, Lordosis or Kyphosis respectively.
Sarah came in on 2/22/18 complaining of vaginal pain and had a rash. She tested positive for hepatitis. On 2/21/18, Sarah took a bath and went to church. While at church she stated having pain and called Patricia to get her. The next day she still was in pain. The reporter examined Sarah, and she had wet soil dirt in the external of her vagina. She had grass and strass on the internal of her vagina. She had multiple redness blisters on the inside of her vagina. Sarah did not make contact, seem shy, and uncomfortable, this could have been due to having the exam done. Sarah told the reporter that she was sitting on the couch without panties on. She said she was not touched or had intercourse with anyone. Sarah is a little slow
When presented with figure 2, it seemed self explanatory to explain the condition. Figure 2 shows the superior view of the vertebral disc, presenting the vertebral arch and the frayed spinal nerves out of the spinal cord. In figure 2 it is shown that in the right image a spinal nerve is compressed due to the nucleus pulposus. The reason that figure 2 is not adequate enough for the physician to properly explain the condition to the patient is because this image shows the outer layer (annulus fibrosus) with the rupture allowing the nucleus pulposus to apply pressure and cause tension to the nerve. Figure 3, on the other hand is a more accurate view of the lumbar vertebrae which depicts the annulus fibrosus still intact and that the disc has entirely moved to compress the nerve. The physician wanted to use a more accurate view of the lumbar vertebrae because if the symptoms worsen due to improper care/prevention one could lose feeling of lower limbs as well as experience dysfunction in the bladder (Mayo). On the other hand the tissues could be more
Before I began my assessment I asked her if she had any perineum pain. K.C. as quoted; “I am feeling okay, but I do have a little pain and it is really not all that bad.” My first response was to look on her medex for pain medications ordered. Before doing so I asked her to rate her pain based on the pain scale (0-10, being 10 the most awful pain that she has ever felt.. She said that she would have to rate her pain as being a number 5. She had an order written for Motrin 8oomg every six hours for pain, prn. I administered the pain medication. Afterwards K.C. asked a few questions in regards to her e...
Have you ever experienced back pain, a sharp uncomfortable pain in the hips, upper butt area that runs through the legs, that’s an annoying constant ache? Maybe lifted something the wrong way, Feeling that burning twinge, maybe a throbbing pain that doesn’t go away. Then you my friend like 75 to 85 percent of people have suffered from lower back pain. Many things can cause lower back pain. Lower back pain is a chronic pain to suffer with, finding a relief of lower back pain before complementary and alternative medicine therapies was not coast effective and can have many consequences and occurs more with stressful situations. Complementary and alternative medicine for lower or regular back pain is a more sufficient coast effect and with physicians