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 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
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.
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.
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.
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.
Joyce is a 40-year-old woman with osteoarthritis of the knee and risk for substance use disorder.
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.
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.
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.
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.
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.
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.
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).
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.
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."