Chronic back pain is one the key health problems encountered especially in primary care. As such, proper evaluation of patients with a history of back pain is an essential step that guides and enables healthcare professionals to come up with suitable interventions as well as management strategies. In the light of this, the evaluation should include a comprehensive history assessment as well as the physical examination. Among the key components to include in the patient’s history assessment includes; a brief description in regard to the onset of the pain, duration, pattern and intensity of the back pain, activities that increase and those that decrease the pain especially the intensity of the pain (Gore et al., 2012). Additionally, the healthcare provider should assess for previous episodes in regard to the pain and previous treatments offered, work history, previous injuries or accidents (involving the back), spine problems, use of tobacco and history of arthritis, cancer, abdominal illness or any related illness.
On the other hand, the physical; examination usually involves various movements that include; straight rise of the leg as well as a neuromuscular examination. Thus, this helps the healthcare provider to assess the sensory as well as the muscular problems. Although effective pin control is an essential aspect in healthcare, healthcare providers should efficiently prevent abuse of the prescribed drugs. In regard to this there are various red flags that can help care providers to detect abuse of these drugs. Among the key red flags include; alternating medications whereby this occurs among patients who obtain drugs from various provider, patients who request specific medications, increased frequency by the patients who request certain prescriptions and incidences of lost medication claims by the patients (Shah, Anupindi & Vaidya, 2015). Thus, healthcare providers should effectively monitor their patients to avoid incidences of drug abuse.
Essentially, prescribing of narcotics especially in treating chronic pain is associated with various ethical implications since they are usually addictive. In the light of this, the healthcare providers should effectively evaluate the benefits and the consequences of prescribing such medications and take the best action and educate the patients of the associated adverse events (Mafi et al., 2013). Thus, I believe that offering NSAIDs in treating patients with chronic pain would be the most suitable and safe treatment since their adverse reactions are usually more predictable and are associated with fewer side effects.
References
Gore, M., Sadosky, A., Stacey, B. R., Tai, K. S., & Leslie, D. (2012). The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings. Spine, 37(11), E668-E677.
Mafi, J. N., McCarthy, E. P., Davis, R. B., & Landon, B. E. (2013). Worsening trends in the management and treatment of back pain. JAMA internal medicine, 173(17), 1573-1581.
Shah, D., Anupindi, V. R., & Vaidya, V. (2015). Cost-utility analysis of Pain Medications used to treat Adult Patients with Chronic Back Pain in the United States. Value in Health, 18(3), A298-A299.
