Back Pain, Essay Example

The causal attributes of back pain may vary from patient to patient. In many of the cases the precise diagnosis is difficult. There are some diagnosis of spinal disorders which may be somewhat direct (i.e., fractures, infections and tumors). There are other diagnoses which are not as straightforward in their explanation. It is important to obtain a precise diagnosis of the cause of the back pain in order to receive the proper pharmaceutical intervention (Assietti et al., 2011; Kallewaard et al., 2010; Marchikanti et al., 2010; Solanski et al., 2011).

The need for the correct diagnosis is attributed to the fact that distinct origins of back pain have the requisite of distinct interventions.  In the precise diagnosis of the cause of the back pain an accurate prescription can be made for the relief of the back pain which is experienced by the patient (Assietti et al., 2011; Kallewaard et al., 2010; Marchikanti et al., 2010; Solanski et al., 2011).Diagnostic examinations are required in order to assess the causes of back pain. The tests which are applied are the following:

1. MRI Scans- These examinations are very helpful in order to evaluate particular conditions by supplying detailed information of the condition of the patient’s spinal discs and neural roots. The MRI scans are very helpful in eliminating the potential of the pain being caused by spinal infections or tumors (Assietti et al., 2011; Kallewaard et al., 2010; Marchikanti et al., 2010; Solanski et al., 2011).
2. CT Scans- This is a very detailed radio graphical analysis which provides images of cross sectional areas of the patient’s body. The CT scans provide views of the skeletal structure of the spine and have the capacity of providing information with regards to spinal stenosis andlacerated discs (Assietti et al., 2011; Kallewaard et al., 2010; Marchikanti et al., 2010; Solanski et al., 2011).
3. X- Rays- These examinations provide information with regards to the structure of the person’s spine and are applied in order to check for instabilities in the spine. The X- ray exams can help to ascertain the cause of the pain which may include fractures, tumors, degenerated discs, lacerated discs or the extent of spondylolisthesis (Assietti et al., 2011; Kallewaard et al., 2010; Marchikanti et al., 2010; Solanski et al., 2011).

Ethical Considerations in the Provision of Narcotics and Opioids for Chronic Back Pain

The ethical considerations of health care providers require that they apply their skills and knowledge in a benevolent manner. The cure for the patient’s back pain may not be possible. The administration of the patient’s suffering is a subject of great concern to the health care provider. Opioids have been frequently prescribed for patients who suffer chronic back pain and many of the medications are composed of opioid derivatives.  In the U.S., there is presently a criminalization and stigma which are associated with the injection of opioids for chronic pain (Ballantyne & Fleisher, 2010).

There is a perception of mutual decision making with regards to the patient’streatment which must consider the potential alternative treatments and results. The health care provider risks the possibility of censure with the liberal prescription of narcotics or opioids (Ballantyne & Fleisher, 2010).

Prescription for Patient’s Back Pain

The prescription of over the counter medications has been proven to be effective in the relief of back pain. The appropriate recommendation for the relief of the patient’s back pain would be NSAIDS (non-steroidal anti- inflammation medications), naproxen or ibuprofen. The NSAIDs have been proven to be very effective in the reduction of pain. The NSAIDs diminish the inflammation and relive the symptoms of back pain. Acetaminophen is another potential over the counter drug which may be applied for the relief of the patient’s back pain.  In the extreme case of severe pain, the health care provider may prescribe acetaminophen in conjunction with opioids (i.e. codeine and hydrocodone) in order to provide the patient with a degree of relief from the back pain (Ballantyne & Fleisher, 2010).

References

Assietti, R., Morosi, M., Migliaccio, G., Meani, L., & Black, J. E. (2011). Treatment of   discogenic low back pain with Intradiscal Electrochemical Therapy (IDET): 24 months follow – up in 50 consecutive patients. In Alexandre, A. et al. (eds.), Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves, Actas Neurochinurigica Supplementum108 (pp. 103- 105), Springer.

Ballantyne, J. C. & Fleisher, L. A. (2010). Ethical issues in opioid prescribing for chronic pain. PAIN, 148: 365- 367.

Kallewaard, J. W., Terheggen, M. A. M. B, Groen, G. J., Sluitjer, M. E., Derby, R., Kapural, L., …& Van Kleef, M. (2010). 15. Discogenic low back pain. Pain Practice, 10(6): 560- 579.

Manchikanti, L., Falco, F. J. E., Boswell, M. V. and Hirsch, J. A. (2010). Facts, fallacies and politics of comparative effectiveness research. Pain Physician, 13: E23- E54.

Solanski, D. R., Koyyalagunta, D., Shah, R. V., Silverman, S. M., & Marchikanti, L. (2011). Monitoring opioid adherence in chronic pain patients: Assessment of risk of substance misuse. Pain Physician, 14(2): E119- E131.