Betty Miller is a 77-year-old female who has had right shoulder pain for 4 weeks. Through the case study, you will follow Betty through a visit to her primary care provider and pharmacist; a home health services for nursing, social services and physical therapy; and a primary care provider follow-up visit.
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Catherine: Chronic Pain with Multiple Co-Morbidities, Using Measurement-Based Tools
Catherine is a 46-year-old woman with Chronic Low Back Pain (CLBP), obesity, poorly controlled diabetes with peripheral neuropathy, and ankle pain on high dose opioids for past 4 years.
Keywords: Anxiety, Back, Chronic, Depression, Diabetes, Joint, Middle Age, Musculoskeletal, Peripheral Neuropathies
Delores: Musculoskeletal Pain and Moderate to Severe Dementia
Mrs. Rose is an 89-year-old, widowed white female who has resided in a nursing home for the past 3 months. Admission was precipitated by inability to function independently, related to Dementia Alzheimer’s –type (DAT) and to widespread arthritic pain. Her mobility is severely limited.
Keywords: Chronic, Dementia, Generalized, Musculoskeletal, Older Adult
Edna: An Older Adult with Chronic Low Back Pain
Edna is a 70-year-old woman with chronic low back pain. After completing the course, you should be able to differentiate the weak link and the treatment targets in older adults with chronic low back pain, articulate realistic treatment expectations for chronic non-cancer pain, and describe a rational stepped care treatment approach for older patients with chronic low back pain.
Keywords: Anxiety, Back, Chronic, Depression, Musculoskeletal, Older Adult
Eric: Acute Pain Management in Patients with Opioid Use Disorder
Eric is a 23-year-old man actively using IV heroin. He presents with right leg pain and swelling after injecting heroin into the muscle.
Keywords: Acute, Anxiety, Chronic, Depression, Musculoskeletal, Young Adult
Interprofessional Management of Acute to Chronic Leg Pain
CA is a 48-year-old female patient who is status post left total knee replacement arthroplasty under a general anesthetic. Patient controlled analgesia was initiated in the post-anesthesia care unit. After transfer to the regular ward, the patient complains of worsening acute post-surgical pain coupled with chronic pain from inflammatory degenerative joint disease.
Keywords: Acute, Adult, Chronic, Depression, Joint, Leg, Musculoskeletal, Post-Surgical
Joe: Chronic Headaches in the Young Adult
Joe is a graduate student with increasing headache frequency for the past 2-3 month. They occur daily and disrupt his coursework and studying. Some are severe with nausea and light sensitivity, while others are mild. In addition to his headaches, Joe experiences neck pain and muscle tension.
Keywords: Chronic, Craniofacial, Musculoskeletal, Neuropathic, Young Adult
Joyce: Osteoarthritis of the Knee and Risk for Substance Use Disorder
Joyce is a 40-year-old woman with osteoarthritis of the knee and risk for substance use disorder.
Keywords: Adult, Chronic, Joint, Musculoskeletal
Luisa Sanchez: Hispanic Older Adult with Acute Neck Pain
Luisa is a 69-year-old Hispanic woman who is having acute neck pain. Her pain began two weeks ago, after she spent two days making tamales for a church function.
Keywords: Acute, Head/Neck, Musculoskeletal, Older Adult
Maeve: Ear Pain
Maeve, a 28-year-old female with limited access to dental care and no dental insurance, is seen with a chief complaint of right temporomandibular pain causing pain in the right ear.
Keywords: Acute, Anxiety, Depression, Head/Neck, Joint, Musculoskeletal, Young Adult
Maria: Pain Treatment in a Patient With OUD
Maria is a 31-year-old Hispanic female with a five year history of lower back pain with intermittent radiculopathy complicated by an approximately two year history of opioid use disorder (OUD). She presents for assistance with her back pain.
Keywords: Back, Chronic, Musculoskeletal, Young Adult
Marty: Perioperative Pain Management
Marty James is a 55-year-old African American female with a 10 year history of left knee pain.
Keywords: Acute, Anxiety, Chronic, Depression, Joint, Leg, Middle Age, Musculoskeletal, Post-Surgical
Mary: Pain in a Patient with Metastatic Cancer
Mary is a 74 year old woman with a history of breast cancer metastatic to the ribs, hypertension, and osteoarthritis. She complains of newly developed right-sided hip pain.
Keywords: Anxiety, Cancer/CancerTX, Chronic, Depression, Joint, Musculoskeletal, Older Adult
Mildred: An Older Adult with Persistent Knee Pain and Dementia
Mildred is 83 years old and suffers from chronic, constant knee pain that prevents her from doing things around the house. She recently moved next door to her son so he can provide the extra help she needs with grocery shopping, cooking, and doing heavier housework. An x-ray of her knee displays moderate to severe knee osteoarthritis.
Keywords: Chronic, Dementia, Joint, Leg, Musculoskeletal, Older Adult, Rheumatic/Fibromyalgia
Mr. Clark: Gout in an Older Adult
Mr. Clark is an 80 year old, moderately overweight Caucasian male who awoke two nights ago with severe pain in his left foot. He has tried elevating his foot and has taken ibuprofen, with minimal pain relief. His wife states that he has some problems with his memory. She states that he has not been able to sleep, and asks the urgent care staff to give him something for the pain as well as something to help him sleep.
Keywords: Acute, Chronic, Dementia, Hypertension, Joint, Musculoskeletal, Older Adult
Mr. Monahan: Chronic Knee and Back Pain
Mr. Monahan is a retired, community-dwelling, 81 year old Caucasian male who was a carpet installer for 50 years. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral knee arthroplasty, GERD and sleep apnea. You are seeing Mr. Monahan in his home.
Keywords: Chronic, Musculoskeletal, Older Adult, Rheumatic/Fibromyalgia
Mr. Wakefield: Wounded Warrier
Mr. Wakefield is a young Army veteran with chronic low back pain and depression. His physical exam demonstrates musculoskeletal pain and lumbar facet arthropathy (joint pain in his lower back).
Keywords: Adult, Anxiety, Chronic, Depression, Musculoskeletal, Rheumatic/Fibromyalgia
Mrs. Johnson: Geriatric Low Back Pain from the Perspective of the Medical Home Model
Mrs. Johnson is an 80-year-old obese woman with progressively incapacitating
low back pain for 1 year.
Keywords: Anxiety, Back, Chronic, Depression, Musculoskeletal, Older Adult, Sleep and Fatigue
Ms. Mondragon’s Acute and Chronic Injuries After a Fall
Ms. Mondragon is a thin, 71-year-old, widowed Hispanic Spanish-Speaking woman whose son is serving as interpreter in the emergency department. Ms. M. fell this morning in her kitchen. She presents with upper back pain, groin pain, and left hip pain radiating anteriorly to the knee.
Keywords: Acute, Back, Chronic, Musculoskeletal, Older Adult, Pelvic, Trauma
Owen: Opioid Overdose Risk and Naloxone
Owen Jones is a 46-year-old man who presents for followup of low back pain with intermittent radicular symptoms and numbness which started ~ 2 years ago following a lifting related injury. He describes the pain as, "Sharp, pinching, and sore."
Keywords: Adult, Anxiety, Back, Chronic, Depression, Musculoskeletal