Please respond to discussion below using current APA edition and 2 academic references within 5 years or less. Must be at least 150 words.
My back hurts so bad I can barely walk” A 35-year-old male painter presents to your clinic with the complaint of low back pain. He recalls lifting a 5-gallon paint can and felt an immediate pull in the lower right side of his back. This happened 2 days ago, and he had the weekend to rest, but after taking Motrin and using heat, he has not seen any improvement. His pain is sharp, stabbing, and he scored it as a 9 on a scale of 0 to 10.
What other subjective data would you obtain?
Subjective data I would try to obtain onset or mechanism of injury is the situation improving or worsening, does the pain radiate from the back to any other areas, I would also inquire about the quality of the pain, the timing and severity, aggravating and precipitating factors, whether or not the pain affects activities for daily living, what is being used to relieve the pain and the efficacy of the treatment.
What other objective findings would you look for?
Other objective findings would include performing a physical focused physical examination of the muscular skeletal system, perform motor, sensor, and reflex function test to determine areas affected. Checking your posture and spine for any changes in the skeletal structure. Requesting that you lift or bend your legs to assess how movement affects your pain, testing the quickness, power, and sensitivity of your muscles.
What diagnostic exams do you want to order? State your rationale for each supported by academic resources.
X-rays: only display the bones and can be used to identify broken or fractured bones, the effects of aging, alterations to the spine’s alignment (Nicol et al., 2023).
A strong magnet’s energy is used in MRI (magnetic resonance imaging) to produce signals that result in several cross-sectional images. A computer analyzes these “slices” of images to create an image of the back. The soft tissues in and around the spine, such as the discs, ligaments, and nerve roots, can sustain injury or develop disease, which an MRI can detect. Since there is no radiation exposure, an MRI offers the greatest benefit with the least amount of risk (Nicol et al., 2023).
Doctors can view inside your body using a computed tomography (CT or CAT) scan. It takes pictures of your organs, bones, and other tissues using X-rays and a computer. It displays more information than a standard X-ray. Any area of your body can undergo a CT scan. It doesn’t take long, and there is no discomfort (Nicol et al., 2023).
Name 3 differential diagnoses based on this patient presenting symptoms.
Strained/sprained lumbar muscles.
Spondylolisthesis
Disk Herniation
Give rationales for each differential diagnosis supported by academic resources.
Strained/sprained lumbar muscles: presentation: pain worse with movement, better with rest, follows traumatic incident or repetitive overuse, limited range of motion, tenderness to palpation of muscles (Casiano & De, 2020).
Spondylolisthesis may manifest as back pain radiating to the buttocks and posterior thighs. Neurologic deficits are typically found in the L5 distribution (Casiano & De, 2020).
Disk herniation Presentation: Typically affects the L4 to S1 segments; depending on severity and nerve root involved, may include paresthesia, sensory change, loss of strength, or reflexes (Casiano & De, 2020).
What teachings will you provide?
Patient counseling and education are consistently the first-line treatments suggested for people with low back pain. No matter how long a patient has had low back pain, doctors should inform them of its benign nature, reassure them that nothing serious is wrong, and encourage them to keep moving. Avoid doing some exercises; for example, sit-ups, leg lifts, toe touches, high impact exercises, and weightlifting should be avoided when your back is hurting. Running, tennis, and other racquet sports should also be avoided until your back feels better. Repetitive motions can aggravate already damaged muscles, tendons, and ligaments. They can also put more pressure on the discs in your low back, which may make your pain worse (O’Hagan et al., 2023).
When bending over to pick up something, use the right bending techniques to reduce back pain. For instance, avoid bending at the waist and only make knee and hip motions when bending to reach for something. Give your back some time to heal if you’ve strained it and are experiencing pain. Your back pain will only get worse if you lift and twist. Lying down might seem like a good idea when your back hurts. Unfortunately, if you don’t move around and stretch out your muscles, you might become stiff, and your pain might even get worse.
Being active by carrying out your regular daily activities, participating in low impact exercises like hamstring stretches, gentle low back exercises, a walking program, or a structured exercise program with physical therapy may help. Bed rest may cause the muscles in your low back to weaken. Your muscles can become stronger, and your spine can become more stable thanks to this (O’Hagan et al., 2023).
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