Management of Lower Back Pain in Narcotic Abusers. By: Braye Rueff. Lower Back Pain. How common is it? 85 % of all people will experience LBP during their lifetime How do you treat LBP: Difficult task! Complex system of Vertebrae/disc/nerves Surrounding soft tissue
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By: Braye Rueff
4 Major Issues:
1) Lower Back Pain: Difficult to Manage: Narcotic Abusers
“Solution” is the “Problem”
1a) The class of drug patients abuse or have abused is one of the primary pharmacological tools for treating LBP
1b) The non-physical factors the abusers may be presenting:
It has been indicated that approximately 90% of persons with opioid dependence have an additional psychiatric disorder, such as major depressive disorder.
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It has been estimated that an emergency department with 75,000 patients per year can expect up to 3,144 visits from fabricating drug-seeking patients
(Longo et al. 2000 and Hansen 2005)
1) both the number of these opioid receptors
2) sensitivity which can result in an increase in tolerance to this class of drugs
Clinical Sig: May need to increase analgesic dosages.
Opioid Induced Hyperalgesia (OIH)
lowering of tolerance for pain
(Merrill et al 2002)
Negative side effects associated with narcotic pain
It is unfair to the patient who is in pain and really has the therapeutic need to withhold such effective medication
Combination: TENS + Acupuncture
How does it work? It delivers electrical stimulation directly to the deep paraspinal tissues, where the nerve pathways leading to the spinal column reside
Outcome: 1) relieve the patient’s pain 2) increase physical activity,
3) reduces the dosage of pain medications prescribed.
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