DOI: 4/24/2013. This is a case of a 59-year-old female customer service representative who sustained injury to her left ankle when she got up after her foot “fell asleep”. As per OMNI notes, patient underwent ligament reconstruction with Brostrom repair on 1/16/2014 and left knee arthroscopy on 10/8/2014. As per office notes dated 6/21/16, the patient returns for interval followup visit. The patient has been working more and is explaining to me that she is having exacerbation of symptoms. The patient admits to increasing neuropathic pain secondary to complex regional pain syndrome. It was mention that the patient has been on Topamax and tramadol which allow the patient to get some improvement. She admits 40% improvement in the pain and she also …show more content…
It was noted that the patient has had increase range of motion and decrease in allodynia due to injection. The patient’s injection has worn off and is in more pain as well as decrease in range of motion noted due to not having the injection performed. It was also mentioned that the patient is doing self-therapy. Currently, the pain is rated as 6 with medication and as 8 if without medications. The pain is located at left knee and ankle. The patient describes it as aching and increased. Physical examination revealed that on palpation of the lumbar facet revealed pain on both the sides at L3-S1 region. There is palpable twitch positive trigger points are noted in the lumbar paraspinous muscles. Motor strength is grossly normal except pain inhibited 4/5 on the left foot eversion and plantar flexion. Examination of the extremity revealed mild increase swelling in ankle and in the 3rd/4th metatarsals. Left ankle reveals increase allodynia and hyperalgesia. Dorsiflexion is 10 degrees. Plantarflexion is 30 degrees. Subtalar joint inversion is 4 degrees secondary to pain. Inversion is 5 degrees, forefoot abduction is 10 degrees, abduction of 20
On History- The patient was a 49-year-old Caucasian male with a chief complaint of pain and weakness in R shoulder abduction and external rotation (dominant shoulder). He was a retired baseball player. He has been a baseball pitcher for 12 years before he retired 5 years
L. H. a 22-year-old female who came into the clinic as a new patient complaining of lower back pain. Vital signs include: height 62 inches, weight 108 lbs., and 16 respirations. The patient stated that her back pain has gone on for quite sometime now (about 2 years total). She works as a nursing assistant in a nursing home in Wahoo. The physician stated that he wanted to taper her off tramadol (she takes 150 mg a day). He also wants to taper her off Effexor as well. The doctor noticed that the painful region was in the patient’s upper left side of her back. He recommended to the patient that L1 to L2 and L2 to L3 facets would benefit from steroid injections. The patient and her mother wanted to make sure they met their
General: Patient is alert, oriented, not in acute distress. Not in labored breathing. Gait is non-antalgic. Cooperative and talkative mood affect. On exam of left knee inspection noticed some swelling compared with the right. Tenderness and swelling in left knee medial aspect. The scar from anterior knee is well healed. No sign of infection. Vascular exam is normal, dorsalis pedis pulses posterior, tibial pulses and capillary refill. Neurologic exam is within normal limits. Sensation and motor is intact. Motor and sensory are intact equal bilaterally. Hyperextension and flexion is within normal limits. Lachman test is negative. Knee anterior drawer test is negative. McIntosh test is negative. Inspection is no ecchymosis but there is a mild swelling in the medial
Rixe JA, Glick JE, Brady J, Olympia RP. A review of the management of patellofemoral pain syndrome. The Physician And Sports Medicine. 2013;09:2023
“Cognitive-behavior therapy refers to those approaches inspired by the work of Albert Ellis (1962) and Aaron Beck (1976) that emphasize the need for attitude change to promote and maintain behavior modification” (Nichols, 2013, p.185). A fictitious case study will next be presented in order to describe ways in which cognitive behavioral therapy can be used to treat the family members given their presenting problems.
The patient tells me this has been ongoing now for the last two months. There was no specific injury or trauma. She was describing a pain and ache in her right leg. She said she was not paying much attention to exactly where it was and elected to go see urgent care on September 3th. I do have that note from the physician that she saw there. At that time, her main complaint was right knee pain. She had x-rays done that showed some mild osteoarthritis and she is here today to follow up on that. She says after that visit, she really started trying to pay attention to where the pain was coming from and she realized it is really coming throughout the whole leg, particularly the thigh area, the knee, down the back of the leg as well, and she also feels it a little into the right buttock. No injury or trauma. There is no real low back pain associated with this. No weakness that she has noticed. No numbness or tingling that she has had. She is having no other joint issues that she can recall. She is not having fevers. There has been no redness or swelling. She is overall feeling okay. She is a little bit more tired than typical. No associated fevers, chills, or other body
Simple musculoskeletal back pain has symptoms of pain in the lumbrasacral area of the back (Jackson & Simpson, 2006). The upper thighs and knees are also known to be affected (Jackson & Simpson, 2006). This pain is usually described as a dull pain (Jackson & Simpson, 2006). Spinal nerve root pain is localised down the leg, and usually continues below the knee and into the feet (Jackson & Simpson, 2006). It has been d...
Nail biting has been regarded as a common habit that tends to begin in the childhood years. For some this is just a childhood phase, but for many it can continue into adult life. Most nail biters are extremely embarrassed or ashamed of this habit. This particular habit usually becomes worse through anxiety or stress. Nail biting is an “unconscious” behavior and most individuals will bite their nails at any time, whether they are in the public eye or at home.
we will examine different issues for different people personally, despite the fact that we are part of a group. This journey will be complicated; however, the reward will be valued. This is a preparation to help others.
DOI: 8/19/2008. The patient is a 64-year old male stock driver who sustained a work-related injury due to stress of employment. The patient was subsequently diagnosed with Degenerative Disc Disease lumbar spine, radiculopathy. As per office notes dated 01/12/2016 revealed that the patient complains of worsening lower back pain. He is having difficulty bending to the right which causes a little more pain. He has been taking Norco 10/325mg approximately three to four times a day. He has great difficulty with range of motion of the lower back. Movements such as rotation, as well as flexion and extension do cause some pain and discomfort. Pain can be sharp or dull at times. In addition, the patient reports that pain radiates
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.
In recent years, there has been ongoing research that supports the fact that hypnosis can be seen as a viable alternative treatment to be used for people dealing with pain and other types of emotional distress. In this article we will uncover case studies highlighting the fact of using cognitive behavioral therapy along with hypnosis to deal with obstetrics.
2. Hypnosis is an altered state of consciousness in which a person loses the power of voluntary action and becomes highly responsive to suggestion or direction.
Hypnosis motivates the attentional manipulation due to the cause of pain and attention activating relatable areas in the brain. According to Raz, A., & Shapiro, T. (2002, p. 87) “Traditionally, hypnosis was studied as one of the most effective behavioural interventions for acute and chronic pain.” Suggestibility to a heightened state is directed by the systematic procedure. Reports were seen to be beneficial on humans who overcame their feeling of pain through hypnotic analgesia. The hypnotic framework rides with the dependency of expecting an ease sensation, that eventually alleviates the pain. A psychiatrist named Freud, who studied at Charcot, had initially used hypnosis as his strategy to convert his patients to the desired trancelike state.
Have you ever been driving your vehicle on the way to a destination, and reach that destination without remembering every part of the way there? If I were to tell you that you are experiencing a natural, normal form of hypnosis, you would probably think I was giving you inaccurate information. What exactly do you know about hypnosis? Did you know it’s a common, normal way of relaxing? If I could take a guess, there is probably a lot about it that you don’t know or understand. Most people know that hypnosis is when someone is hypnotized or put into a “trance”, right? Hypnosis is one of many ways that therapists can help clients with the problems in their lives.