Management and Evaluation of Back Pain revised

Management and Evaluation of Back Pain
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Management and Evaluation of Back Pain
In the evaluation of a patient presenting with back pain, I would foremost observe his posture during movement as well as when standing. Besides, I would inquire about their health history as according to Papadakis, McPhee, and Rabow (2014), history is the most critical factor in the evaluation and assessment of the musculoskeletal system. Thus, some of the questions I would ask include the details on the start of the pain, its intensity, duration and pattern of the current episode. I would also ask whether they are on any medications as some medications may cause musculoskeletal problems. Besides, I would inquire about their occupation hobbies and any repetitive movements they recently had.
The inspection of joints for symmetry and function would be vital in the physical assessment. I would check for any deformities or skin color change. I would also palpate the joints and note any swelling, monitor the temperature of the skin as well as the bony articulation. I will also assess the pain and what reduces it. I would also ask for a range of motion to identify any limitations. I would also check neurovascular functions by examining any tingling feeling or numbness in the limbs (Jarvis, 2016).
According to Cheatle (2015), some of the warning signs of drug abuse, confusion, poor coordination, euphoria, as well as heightened pain on higher dosages. Hostility or excessive mood swings, decrease or increase in sleep, unusual energy, and seeking more prescriptions from other doctors are other signs of drug abuse.

Adhering to ethical principles of non-maleficence, beneficence, respect for justice and autonomy is critical in prescribing narcotics for the treatment of chronic pain. It is also vital to adhere to the controlled substance act to mitigate the development of drug dependence.
I would prescribe Tylenol for low back pain as it is non-steroidal and is easily obtainable. Tylenol can come in stronger doses depending on the prescription. Muscle relaxants can also help for patients with severe muscle spasms that come along with back pain. Minimal physical activity and bed rest is also helpful for patients with mild low back pain. Opiate painkillers are highly susceptible to abuse. Thus, regulated prescription such issuing a dosage for three days only would help in ensuring appropriate use of the drug (Thomas et al., 2016)
References
Cheatle, M. D. (2015). Prescription opioid misuse, abuse, morbidity, and mortality: balancing effective pain management and safety. Pain Medicine, 16(suppl_1), S3-S8.
Jarvis, C. (2016) Pocket Companion for Physical Examination and Health Assessment. St. Louis, Missouri: Elsevier.
Papadakis, M., McPhee, S., and Rabow, M. (2014). CURRENT Medical Diagnosis and Treatment Study Guide. New York: McGraw-Hill Professional.
Thomas, D., Frascella, J., Hall, T., Smith, W., Compton, W., Koroshetz, W., & Volkow, N. (2015). Reflections on the role of opioids in the treatment of chronic pain: a shared solution for prescription opioid abuse and pain. Journal of internal medicine, 278(1), 92-94.