NUR231
Explanation of the pathophysiology of John’s lower back pain and effectiveness of NSAIDs for pain management
Pathophysiology of John’s lower back pain
Based on check-up conducted by John’s General Physician, John was suffering from acute pain in spinal columns of thoracic region, starting from 12th thoracic vertebrae to1stlumbar vertebrae. Acute pain worst at 3 months causing chronic pain. Reason of acute pain was calcium and protein deficiency in binding formation of bones. Because of this reason, John was unable to do his daily activities in a comfortable manner as it was done. John should have experienced nociceptive pain arising from stimulation of nociceptors by noxious stimuli such as tissue injury or inflammation. If acute pain transferred into chronic pain, there would have neuropathic pain due to compression of MRI on John’s nervous system (Yoon, & Oh, 2018). In such circumstances faced by John after MRI, Buprenophine can be used for the pain management. It is an effective agent for management of severe pain where any alternative treatment is not there. This dosage is not highly recommended because of its side effect factors.
Effectiveness of NSAIDs for pain management
Non-steroidal anti-inflammatory drugs include both traditional and selective cyclooxygenase that are helpful in the reduction of inflammation of bone in older people. NSAIDs are widely chosen by people due to integrated role of COX pathway that performs biochemical recognition of pain. Medicines used under NSAIDs are used for treatment of osteoarthritis, rheumatoid arthritis, spondylitis and other assorted pains that affect proper functioning of joints in human body (Urden, Stacy, & Lough, 2017). However, continuous usage might lead to generation of gastrointestinal problems mainly in older patient that might create an unnecessary imbalance in health.
Analgesics recommended for John
For giving relief to John, radiotherapy can be conducted to help in reducing size of tumors formed. Locking of nerve root can also be done by oral consumption of steroids to lessen pain generated under lesion formation (Chou et al., 2017).
Surgical intervention can be performed to detect any sort of negative impact that can worsen effect of tumor formed in John’s vertebral column. It should be made sure that prevention of venous thromboembolism and pressure sores. Percutaneous vertebral augmentation technique can be applied as it does not create any sort of major trauma regarding tissue and blood loss taking place (Tomasian, Wallace, & Jennings, 2017).
Usage of local anesthesia by procedure of vertebroplasty can help in lowering morbidity and mortality that can occur during open spinal surgery of John back (Lausten, Rasmussen, & Gazerani, 2018). Infiltration of intraosseous lidocaine combined with intravenous infusion of remifentanil can also help get positive result regarding recovery from surgery pain performed (Kassamali et al. 2010).
Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., Fu, R., Dana, T., Kraegel, P., Griffin, J., Grusing, S., &Broadt, E. (2017). Nonpharmacologic therapies for low back pain: A systematic review for an Americancollege of physicians clinical practice guideline. Annals of Internal Medicine, 166(7), 493-505. Retrieved from: http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=28192793&S=R&D=mnh&EbscoContent=dGJyMNLe80SeqLA4v%2BvlOLCmr1GeprFSsa%2B4SK6WxWXS&ContentCustomer=dGJyMPGptFCyprJIuePfgeyx44Dt6fIA
Dogan, N., & Goris, S. (2018). The Effect of Pain Levels and Pain Beliefs of Elderly People Living in Nursing Home on Quality of Life. International Journal of Caring Sciences, 11(2), 947. Retrieved from: http://internationaljournalofcaringsciences.org/docs/36_dogan_original_10_2%20(1).pdf
Kassamali, R. H., Ganeshan, A., Hoey, E. T. D., Crowe, P. M., Douis, H., & Henderson, J. (2010). Pain management in spinal metastases: the role of percutaneous vertebral augmentation. Annals of oncology, 22(4), 782-786.
Lausten, M. B., Rasmussen, S., &Gazerani, P. (2018). Association between the ABO blood types and post-operative pain. Eur Neurol Rev, 13, 38-43. Retrieved from: http://vbn.aau.dk/files/281517584/EU_NEURO_13_1_p38_43.pdf
Tomasian, A., Wallace, A.N., Jennings, J.W. (2017). Benign spine lesions: Advances in techniques for minimally invasive percutaneous treatment. American Journal of Neuroradiology, 38(5), 852-861. doi: https://doi.org/10.3174/ajnr.A5084
Urden, L. D., Stacy, K. M., & Lough, M. E. (2017). Critical Care Nursing: Diagnosis and Management. Retrieved from: https://books.google.com/books?hl=en&lr=&id=VIglDgAAQBAJ&oi=fnd&pg=PP1&dq=pain+management+in+older+people+books&ots=jQwdPe4uHj&sig=nAYJCB-oXe7iGveoq0Do6F5zxOY
Yoon, S. Y., & Oh, J. (2018). Neuropathic cancer pain: prevalence, pathophysiology, and management. Korean J Intern Med, 33(6), 1058-1069. doi:10.3904/kjim.2018.162