CASE STUDY B Chronic Pain MS. J. is a 30-year-old healthy single mother with two
ID: 138010 • Letter: C
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CASE STUDY B Chronic Pain MS. J. is a 30-year-old healthy single mother with two children. She has worked as a paramedic in her community for 6 years. She and her partner responded to a call involving a man who had been drinking heavily at a family party and who was partially conscious. When she and her partner attempted to transfer the 100-kg man to a stretcher, the man grabbed her neck, causing her severe pain. Ms. J.'s doctor diagnosed a spinal injury and completed papers that would permit Ms. J. to be absent from work. He recommended rest and the application of heat and cold to the neck. One week later, Ms. J. saw him again and reported continuing pain. She was referred to a specialist who told her she had a herniated disc in the cervical area of her neck and would require ongoing care and rehabilitation. Ms. J. has been on disability leave for 6 months, during which she has continued to have severe neck, jaw, and back pain. She takes acetaminophen with codeine as required and sees a physio- therapist and a registered massage therapist routinely in anExplanation / Answer
1 Chronic pain is a significant problem .Successful management of pain depends on the accurate identification of factors which generates or modifies pain perception and using strategies that effectively target these factors.Chronic pain syndrome following SCI is difficult and is only partially effective.It is therefore essential to comprehensively evaluate the type of pain and psychosocial factors contributing with emphasis on functional capabilities,behavioural responses to pain,adjustment to disability,and degree of motivation.Rehabilitation principles should focus on pain management programme,to increase self -efficacy and promote great activity and participation.Goals may be set in a range of domains ,including activities of daily living,physical fitnessand endurance ,vocational activities,recreational activities ,relationships and family and mood.
2These are serious medications and they should be used only in the most extreme cases and work to raise your threshold for pain.So even i your body is in a lot of pain ,the opiod effect on your brain convinces that its not that bad.
3 Because cervical spine is the most vulnerable part of the spine.
4 Massage ac tivate the pain gate mechanism and so produce short-lived analgesia.
5Excercise help to improve chronic musculoskeletal pain and may indirectly influence neuropathic SCI pain.Shoulder pain is one of the most disabling and frequent cause of mechanical pain.Shoulder range of motion excercise be started as early as possible after injury to minimize pain.Excercise helps in releasing chemicals called Endorphins.it also helps to reverse the effects of de-conditioning on the body and builds strength
it is important that the excercise program contains strengthening,aerobic fitness,balance and coordination,posture and flexibility.When choosing excercises to include in the routine,choose movements that balance out these forces on the shoulder joint.Being active is important to keep the body fit and conditioned and to keep the pain levels under control
6 it blocks pain signals and reduce the perception of pain in the brain.it also helps in stimulating the production of endorphins and eliminates trigger points ,tender areas in the muscles and fascia that cause local or reffered pain.
7 Most common barriers to full time employment are problems with transportation,health and physical limitations,lack of work experience and discrimination by employers .
8 When an accident occurs following a spinl cord injury ,life is changed forever.Because of advanced science and technology thayt has come from extensive research ,people are able to leadclose to normal lives with physical therapy.Therefore with excercises and massages she will be able to lead a normal life.
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