Question

Case study Derek Bairstow is a 48-year-old removals operative. He has for the past 3 months. The intensity of the pain has increased graduallig from lower days and as a result he has not been able to go to work. Although he epast c his back, he has a very physical job working for a removals firm and belnotremeesouple strain is the cause. Derek has been taking non-steroidal anti-inflamotinual but finds they provide little relilet. The pain is such that he finds it dificus for t sleep. Today he has visited his GP for more advice. Derek is recently divo and their children now live 100 miles away. He informs the GP that he ha low and has been finding it difficult to concentrate on anything and with friends. The GP records a set of vital signs and asks Derek to questionnaire (PHQ-9)-see below. The GP reviews a CT scan to rule out spinal injury 1. beenally over the past couple eves the pain b GPandhasws a patient heaith has a vodd sy Derek's analgesia regime and refers 468 The GP recorded the following vital signs and recorded the following responses patient health questionnaire. Observation 36.3C 72 beats per minute 13 breaths per minute 134/89 mmHg Normal 36.1-38.0'C range 51-90 beats per minute 12-20 breaths per minute 111-219 mmHg (systollicj ange Vital sign Puse: Blood pressure Patient Health Questionnaire (PHQ-9) Over the past 2 weeks have you been bothered by any of the following problems? I have little interest in doing things - More than half the days (2) Feeling down, depressed, hopeless-More than half the days (2) Trouble sleeping, staying asleep or sleeping too much -More than half the days (2) Feeling tired or having lttle energy - More than half the days (2) Poor appetite or over eating-Several days (1) Feeling bad about yourself-or that you are a failure or have let yourself or your family down? - Nearly everyday (3) Trouble concentrating on things, such as reading the news More than half the days (2) Moving or speaking so slowly that other people could have noticed? paper or watching television? Or the opposite - being so fidgety or restless that you have been moving aroun than usual? -Not at all (0) a lot more Thoughts that you would be better off dead, or of hurting yourself in some way?-No Score 14/27- Mild Depression me way?- Not atall/o

Answer 1

Q. No. 1. Answer :

Mr. Derek is suffering from " low back pain ".

Back pain is classified into middle back pain (thoracic pain)

And low back pain.

Low back pain due to stress and insecurity feeling and due to depression it may come.

In these case study the patient is having stress due to diverse of wife and children also living very far from him.

Q. No. 2 . Nonsteroidal anti inflammatory drugs :

These drugs inhibits the cyclooxygenase enzyme so that prostaglandines production may decreases and it leads to pain may reduces.

Side effects :

Gastric toxicity

Renal toxicity

Stomach pain,

Heart burn,

Tendency to bleed more,

Allergies,

Liver and kidney problems and high blood pressure.

Q. No. 3. Answer :

Further treatment options and advices :

* analgesics can be provide, to reduce pain. Ex : diclofenac.

* muscle relaxants also can advise.

* self care like heat application and physical exercises.

* de-stressing techniques like yoga , meditation ect.

* acupuncture.

* Transcutaneus electronic nerve stimulation ect.

* if not cure advice for spine surgery.