Low back pain is a significant health problem in the United State and is most commonly treated in primary healthcare settings. About 10% of patients develop chronic pain, which leads to early retirement and high health care costs (Becker et al.,2010 ). In 1998,total U.S. health care expenditures for low back pain were estimated at $90 billion. Low back pain also incurs high indirect costs due to lost productivity (Chou et al.,2011 ). Reducing unnecessary treatments such as imaging and ineffective pharmacological treatments can decrease costs associated with acute low back pain. This paper outlines the evidence-based practice approach to first line treatment of acute low back pain. Practitioner’s should be aware of the lack of evidence for first …show more content…
In the United States low back pain is the fifth most common reason that patients seek medical advice (Hoy, Brooks & Buchbinder, 2010). Approximately one-quarter of US adults reported having low back pain lasting at least 1 whole day in the preceding 3 months (Srinivas, Deyo, & Berger ,2012 ). Age is a more common risk factor for the development of low back pain with an overall increase up to age 65 years (Waterman, Belmont & Schoenfeld,2012). Some studies have shown that the highest incidence occurs in the third decade (Hoy, Brooks & Buchbinder, 2010). Shiri et al., found that increased body mass index was associated with an increase risk of acute low back pain. Low educational status has been shown to be associated with an increased occurrence of low back pain ( Hoy, Brooks & Buchbinder, 2010). Additionally, the occurrence of acute low back pain has been shown to be increased in manual workers and occupations that involve manual labor, bending, and twisting (Hoy, Brooks & Buchbinder, 2010 ). There are few studies that have investigated whether there are an association between back pain and mortality. A systemic review by Hoy, Brooks & Buchbinder (2010) found that low back pain was more prevalent in women than …show more content…
Heat wrap application plus NSAID compared with NSAID alone was found to be more effective than NSAID alone at reducing pain (McIntosh & Hall, 2009 ). Not only does heat therapy improve pain in low acute back pain, but evidence has also shown that heat therapy may be more effective at improving patient disability when compared to NSAIDs alone (McIntosh & Hall, 2009). The AHCPR guidelines found that NSAIDs have a number of potential side effects, with the most frequent gastrointestinal irritation. They recommend the decision to use these medications be guided by comorbidity, side effects, cost, and patient and provider preference ( McIntosh & Hall,
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).”
A. Chronic pain signifies a developing public health issue of huge magnitudes, mainly in view of aging populations in developed countries (Russo).
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
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).
Pain is not always curable but effects the life of millions of people. This essay examines the Essence of Care 2010: Benchmarks for the Prevention and Management of Pain (DH, 2010). Particularly reflecting on a practical working knowledge of its implementation and its relevance to nursing practice. It is part of the wider ranging Essence of Care policy, that includes all the latest benchmarks developed since it was first launched in 2001.
Institute of Medicine Report from the Committee on Advancing Pain Research, Care and Education. (2011). Relieving Pain in America A Blueprint for Transforming Prevention, Care, Education and Research. Retrieved from http://books.nap.edu/openbook.php?records_13172
The word “chiropractor” has two word origins, the Greek words cheir and praxis; meanwhile, cheir means “hand” and praxis means “practice.” Also, most of the work that chiropractors do is done by hand (Pike para. 5). In 2002, going to a chiropractor was found to be the most commonly used program for therapy. Seventy-four percent, about 4 million, of people that had back pain went to a chiropractor to get treated. Among that 74 percent of people, 66 percent of them stated that they got “a great benefit” (Pike para. 9). Many chiropractors work full time but 1 out of 3 chiropractors work part time. Chiropractors work whenever their patients need them, even on w...
Currently, I am involved in a prospective cohort study with other colleagues from King Fahad Medical City that aims to study the effect of a low back care educational program on low back pain prevalence among health-care professionals.
Osteoarthritis is not a curable condition, but it can be treated using both pharmacological and nonpharmacological methods. Mild analgesics are a common form of treatment for OA, including Acetaminophen and NSAIDs, taking into consideration other co-morbidities that may be present. It is recommended that adults over 75 years of age utilize topical NSAIDs rather than oral for treatment of the pain (Tugwell et al, 2012). Research by A...
chronic pain could be handled at the bedside with no need to await a doctor's
Paanalahti, K., Holm, L. W., Nordin, M., Asker, M., Lyander, J., & Skillgate, E. (2014). Adverse events after manual therapy among patients seeking care for neck and/or back pain: a randomized controlled trial. BMC Musculoskeletal Disorders, 1577. doi:10.1186/1471-2474-15-77
Fibromyalgia is an extremely disabling condition associated with chronic widespread musculoskeletal pain and reduced pain thresholds (Wolfe et al., 2010)(Kelley et al., 2011). Observational studies have shown that over a 12 month period 25% of men and women surveyed over the age of 65 will consult a primary care physician for musculoskeletal pain (Jordan et al., 2010). Overall, between 46% and 80% of people over the age of 65 report experiencing pain on a daily basis and 15% of women and 10% of men over 50 report widespread musculoskeletal pain (Soldato et al., 2007; Thomas et al., 2004). The Centers for Disease Control and Prevention estimated in xxxx that fibromyalgia patients generated $6000 per patient per year in healthcare costs where as another recent study of administrative claims found that fibromyalgia healthcare costs may exceed $18,000 per patient annually (Wolfe et al., 1997). In a population study of ten chronic diseases, fibromyalgia was highest ranked for healthcare not received in the previous year and in long-term disability, pain, and poor self-rated health by survey participants (Kasman and Badley, 2004).
Chronic lower back pain is a major health disorder in the world today (Mendelson, Selwood, Kranz, Loh, Kidson, Scott, 1983). It can cause many physical, mental, and emotional problems on the victim (Mendelson, Selwood, Kranz, Loh, Kidson, Scott, 1983). Many people find their work so unbearably painful that they often have to stay home. Others experience depression, inactivity, and social isolation (Kaplan, Sallis, Patterson). Treatments range from the conventional methods such as medication and surgery to the alternative or unconventional methods such as acupuncture. However, only a small percentage of low back pain patients have the type of condition for which surgery can be used so acupuncture is becoming more popular (Lehmann, Russell, Spratt, 1983).
The major concepts deduced from the hypothesis fall under three categories: (1) multimodal intervention, (2) attentive care, and (3) patient participation. Multimodal intervention includes the concepts of potent pain medication, pharmacological adjuvants, and non-pharmacological adjuvants. Attentive care relates to the assessment of pain and side effects and intervention along with reassessments. Patient participation includes goal setting and patient education. The resulting outcome of these three categories working together is the balance between analgesia and side effects.
Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The Epidemiology of low back pain. Best Practice and Research Clinical Rheumatology, 24, 769-781. http://dx.doi:10.1016/j.berh.2010.10.002