Ava is a 28-year-old Puerto Rican woman who is seven months pregnant. She complains of anterior pelvic pain that began several weeks ago.
Access Current Interactive Modules
Betty Miller: An Older Female with Right Shoulder Pain
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.
Keywords: Acute, Arm, Depression, Joint, Musculoskeletal, Older Adult
Beverly: Burning Mouth Syndrome and Related Orofacial Pain
Beverly is a middle-aged woman with pain in the roof of her mouth, tongue and occasionally sides of her mouth.
Keywords: Anxiety, Chronic, Craniofacial, Head/Neck, Middle Age, Neuropathic
Breast Pain
Follow three case studies that cover pain with breastfeeding, mastitis, and postmastectomy pain syndrome along with other breast pain topics.
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
Charlie: Opioid Misuse Following Wisdom Teeth Extraction (Teenager)
Charlie is a 17-year-old Caucasian male, accompanied by mother Sarah. He is about to undergo surgical extraction of maxillary third molars. . This case centers on the appropriate prescribing of opioids for post operative dental pain. It describes the role of the pharmacist in identifying suspected opioid misuse, abuse and diversion. Finally the case presents an example of opioid misuse and diversion and the consequences of such misuse.
Keywords: Acute, Adolescent, Craniofacial, Head/Neck, Post-Surgical
Christine: Orofacial Pain
Christine is a 30-year-old woman referred by her local ENT doctor. She says she's experiencing excruciating pain in her jaw.
Keywords: Adult, Anxiety, Chronic, Craniofacial, Depression, Head/Neck
Courtney: Perioperative Pain Management for Pediatric Patients
This module follows Courtney, a now 19-year-old woman who underwent surgery to correct idiopathic scoliosis at 14. It discusses the appropriate approach to the management of pain with adolescents undergoing surgery for idiopathic scoliosis.
Keywords: Acute, Adolescent, Back, Post-Surgical
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
Devon: Sickle Cell Disease and Pain
‘Devon’s Disparate Dealings: Sickle Cell Disease and Pain’ presents the case of a 15-year-old black male with sickle cell disease who presents to the emergency department in severe pain.
Keywords: Acute, Adolescent, Chronic, Depression, Generalized, Joint, Sickle Cell/Cardiovascular
Diana The Declining Dancer: Chronic Pelvic and Jaw Pain
Diana is a 19 year-old woman with pelvic pain and jaw pain since adolescence. She is seeing her provider for advice on how to manage her pain as it seems to be getting worse and is limiting the things she likes to do like dance and eat her favorite foods.
Keywords: Chronic, Chronic Pelvic, Craniofacial, Head/Neck, Pelvic, Young Adult
Donald Williams: Older Adult Right Total Knee Arthroplasty
Donald Williams is a a 77-year-old veteran with osteoarthritis and an old football injury to his right knee. He has just undergone a right knee total arthroplasty 5 days ago.
Keywords: Acute, Older Adult, Post-Surgical, Rheumatic/Fibromyalgia
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
Harold: Trauma Pain
Harold is an adult male with pain from trauma experienced in a car accident. This case covers assessing the aspects of the pain experience in a trauma patient with substance use disorder by integrating the health history into the treatment decision-making process, examining multimodal approaches to treat acute trauma across transitions of care, recognizing the biopsychosocial impact of the treatment of acute pain in patients with substance use disorder, and designing an appropriate treatment plan using case-based learning to address acute trauma related pain in patient with substance use disorder.
Keywords: Acute, Adult, Chest/Breast, Depression, Generalized, Head/Neck, Leg, Trauma
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
Jane: Acute Dental Pain
A 35-year-old woman presents to the hospital emergency department with pain in the lower jaw.
Keywords: Acute, Adult, Craniofacial, Head/Neck
Joan: Pain Policy Analysis and Advocacy
Joan is a breast cancer survivor turned patient advocate. Learn about policy and advocacy through her journey following a double mastectomy and subsequent surgeries.
Keywords: Acute, Cancer/CancerTX, Chest/Breast, Middle Age
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
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
Margaret Anderson: An Older Adult with Limited Communication
Margaret Andersen is an 85-year-old woman with limited communication who demonstrates changes in behavior two weeks after entering a nursing care facility.
Keywords: Acute, Dementia, Generalized, Head/Neck, Non-Pain Condition Specific, Older Adult
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
Melanie: Acute to Chronic Orofacial Pain
Melanie is a 15-year-old girl with jaw clicking with and without pain, and frequent headaches over the last three months. This course illustrates the foundational underpinnings of pain, pain assessment and pain management strategies using a longitudinal case of acute to persistent/chronic orofacial pain with mixed nociceptive and neuropathic phenotypes.
Keywords: Acute, Adolescent, Chronic, Craniofacial, Head/Neck
Melissa: Medication Overuse Headache
Recognizing medication overuse headache in patients presenting with chronic migraine. In this case study, we present a 39-year-old woman who has been experiencing near daily headache for the last 4 months and her successful treatment.
Keywords: Adult, Anxiety, Chronic, Craniofacial, Depression, Head/Neck, Neuropathic
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
Morgan: Adolescent Headache Case
This is a case of a fourteen year old girl with worsening headaches. The case covers four months, beginning with entries into her video diary ("vlog" or "video blog"). She explores several approaches to headache management in a series of encounters with health professionals.
Keywords: Acute, Adolescent, Anxiety, Chronic, Head/Neck, Neuropathic
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. Frank: Pain Assessment in Cognitively Impaired Older Adults
Mr. Frank is an 80-year-old nursing home resident. Recent years have been marked by progressive cognitive decline attributed to Alzheimer’s disease. Two days prior to admission, the nursing home staff noted decreased oral intake and resistance to care but were able to dose usual medications. This progressed over the subsequent day with Mr. Frank noted to be agitated, resistant to care and uncharacteristically aggressive. Transfer to acute care facility was arranged after Mr. Frank fell from his chair.
Keywords: Dementia, Generalized, Older Adult, Trauma
Mr. Gateway: Acute and Chronic Head Pain
Mr. Gateway is a 52-year-old male smoker with a history of substance abuse with recurrent laryngeal cancer who presents with increased throat and neck pain, dysphagia (pain with swallowing), and dehydration.
Keywords: Acute, Cancer/CancerTX, Chronic, Head/Neck, Older Adult
Mr. Jones, Mrs. Hubbard, Mrs. Miller, and Mr. Nguyen
Follow 52-year-old Mr. Jones, 78-year-old Mrs. Hubbard, 38-year-old Mrs. Miller, and 45-year-old Mr. Nguyen as their care teams navigate opioid management for their acute pain once hospitalized.
Keywords: Acute, Acute/Subacute, Adult, Diabetes, Hypertension
Mr. Lane: Acute Farm Injury with Chronic Pain
This case presentation follows a 43-year-old farmer named Mr. Lane who injured his right arm after it got stuck in a combine. He was then air lifted to a tertiary care center. The case includes Mr. Lane's initial injury, acute pain, and the development of chronic pain and acute on chronic pain.
Keywords: Acute, Adult, Anxiety, Arm, Chronic, Depression, Neuropathic, Trauma
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. Smith: Chronic Pain in an HIV-infected Patient with a History of Substance Abuse
Mr. Smith is a 46 year-old male with a history of HIV, hepatitis C cirrhosis, and substance abuse, presenting with bilateral hip pain.
Keywords: Chronic, HIV, Middle Age, Non-Pain Condition Specific
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. Farley: Chronic Temporomandibular Joint and Fibromyalgia Pain
Mrs. Christine Farley has been suffering from temporomandibular joint (jaw) and myofascial (muscular) pain, and you are asked to be part of her inter-professional team to advise on how to best help manage her pain.
Keywords: Adult, Chronic, Craniofacial, Depression, Generalized, Head/Neck, Rheumatic/Fibromyalgia
Mrs. Jackson: The Transition from Acute to Chronic Pain in a Cancer Survivor
Ms. Jackson is a 38-year-old, African American nurse who completed treatment for triple negative breast cancer 5 months ago. She opted for bilateral mastectomy, radiation, and chemotherapy. The patient is frustrated that she still experiences pain, states “it’s ruining my life."
Keywords: Acute, Adult, Arm, Cancer/CancerTX, Chest/Breast, Chronic, Generalized
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
Mrs. Smith: Postoperative Pain - Inroads Into Pain Management
This module follows an older adult named Mrs. Smith as you explore the physiological and pathophysiological mechanisms for how acute postoperative pain can lead to chronic pain and relevance to post-thoracotomy pain.
Keywords: Acute, Chest/Breast, Older Adult, Post-Surgical
Mrs. Wright: Opioid Conversion in Medically Complex Patients
The module follows Mrs. Wright, a 65-year-old woman with a past medical history that includes chronic low back pain, anxiety, hypertension, diabetes and chronic kidney disease.
Keywords: Acute, Anxiety, Diabetes, Hypertension, Leg, Older Adult, Post-Surgical
Mrs. Wright: Opioid Use Risk and Risk Mitigation
The module follows Mrs. Wright, a 65-year-old woman with a past medical history that includes chronic low back pain, anxiety, hypertension, diabetes and chronic kidney disease. Mrs. Wright has been admitted to the hospital for repair of a broken ankle. You, the learner, will assist the orthopedic and pain teams with her care.
Keywords: Acute, Anxiety, Diabetes, Hypertension, Leg, Older Adult, Post-Surgical
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
Ms. Rhodes: Chronic Pelvic Pain
Ms. Rhodes is a 46-year-old woman with CPP: Stage IV endometriosis (cyclic component of pain treated with continuous oral contraceptives), abdominal and pelvic floor muscle pain, vestibulodynia, IBS with constipation, possible IC, anxiety and depression and sexual dysfunction.
Keywords: Anxiety, Chronic, Chronic Pelvic, Depression, Middle Age
Ms. Tatum Trauma Pain and Opioid Use Disorder
Ms. Tatum is a 30 year-old woman with a history of opioid use disorder (heroin and fentanyl) who has been treated for 2 months with buprenorphine/naloxone (Suboxone) in a substance use disorder treatment program. 4 months after she transitioned her medications to her PCP, she was in a Motor Vehicle Accident and sustained multiple left-sided rib fractures as well as a jaw fracture. She has severe pain in the face, neck, and ribs and needs an acute pain management plan.
Keywords: Acute, Chest/Breast, Generalized, Head/Neck, Trauma, Young Adult
Nestor: 7-Year-Old Non-Verbal Boy with Apparent Pain
Nestor is a 7-year-old non-verbal developmentally disabled boy with pain on movement for six months.
Keywords: Child, Chronic, Generalized, Non-Pain Condition Specific
Neuropathic Pain Mechanisms, Neuromodulating Agents and Medical Home Model
This foundational course covers terms and concepts of neuropathic pain, anatomical basis for neuropathic pain, clinical applications of aberrant nociceptive processing; general concepts of pharmacological treatment of neuropathic pain, anticonvulsants, anti-depressants and other neuromodulating agents; medical home models, treatment planning in the medical home context, motivating patients to participate in comprehensive care.
Keywords: Acute, Adult, Chronic, Generalized, Neuropathic, Other
Opioids: Perspectives, Use Cases and Safe Management
In this foundational module, learn more about the global challenge of pain care, applications of opioids globally, features of specific opioids available locally; opioids in context, definitions of tolerance and physical dependence, management of chronic non-cancer pain; safe management definitions: clear lines and gray areas, societal impact of prescription drug abuse, assessment and management of risk in the physician’s office.
Keywords: Acute, Adult, Chronic, Generalized, Other
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
Pain Prevalence, Assessment and Treatment
This foundational module covers US versus global pain prevalence, barriers to pain treatment, and assessment of how own pain experiences and pain treatment attitudes will impact patient care.
Keywords: Acute, Chronic, Middle Age, Other
Pam: Post-Mastectomy Pain Syndrome
Pam is a 41-year-old woman diagnosed with breast cancer approximately one year ago. Pam underwent treatment including a bilateral mastectomy and subsequent breast reconstruction. Now she is experiencing pain that she feels should be improving.
Keywords: Adult, Anxiety, Chest/Breast, Chronic, Neuropathic, Post-Surgical
Peter James: A Veteran with Phantom Limb Pain
Peter James is a 49-year-old veteran with phantom limb pain. While in the reserves he was injured by an IED in Afghanistan. His lower left leg was amputated at Walter Reed. He wants to better control his phantom limb pain so he can take on a farm management opportunity.
Keywords: Anxiety, Chronic, Depression, Leg, Middle Age, Neuropathic, Peripheral Neuropathies
Sarah: Widespread Pain and Fibromyalgia
Sarah suffers whiplash following a car accident. She then goes on to develop widespread pain and associated fatigue. Her pain interferes with work and daily activities.
Keywords: Acute, Chronic, Depression, Generalized, Head/Neck, Rheumatic/Fibromyalgia, Sleep and Fatigue, Trauma, Young Adult
Sharee: Adolescent Sickle Cell Disease
Sharee is a teenage girl coping with pain crises related to sickle cell disease (SCD). The case provides a history of the disease onset and progression from infancy though high school as seen from her perspective explained by case principals. The case then provides details of a pain crisis episode as she prepares to transition from high school to college.
Keywords: Acute, Adolescent, Chronic, Generalized, Sickle Cell/Cardiovascular
Tylee: The Story of Sickle Cell Disease (SCD) Related Pain
Tylee is a 20-year-old male who has suffered with Sickle Cell Disease (SCD) all of his life. This longitudinal case covers his diagnosis, medical history and his pain from age six months to current age.
Keywords: Chronic, Generalized, Sickle Cell/Cardiovascular, Young Adult