Chronic Low Back Pain - Nursing Depo

Write a scholarly case study that will compare and contrast two possible ways of treating a chronic health condition

Topic: Acupuncture vs pharmacotherapeutics for a patient with chronic low back pain

Write a paper about the patient experiencing low back pain, compare and contrast the two different ways of treating the problem with either acupuncture or pharmacotherapeutics

Analyze the options and choose the most appropriate plan for patient based on their unique and individual health needs and desires

Include:

Introduction: Introduce the patient demographics, complaints, and discuss key concepts related to the topic
Setting and social dynamics (community clinic in New Jersey)
INCLUDE Subjective information: Chief complaint, HPI, PMH, PSH, FH, SH, ROS
INCLUDE Objective information: Physical exam and any known results
Medical decision-making and clinical impression (diagnosis)
Introduction of two different evidence-based, peer-reviewed articles or treatment guidelines for the chosen diagnosis – chronic low back pain
Compare and contrast the two treatment options or approaches- Acupuncture vs pharmacotherapeutics
Assess and include analysis of the merit and soundness of research (i.e. discuss which treatment has more research or better research)
INCLUDE which treatment option was chosen for the patient scenario and provide justification on why it was better for them
Include specific plans or interventions, recommendations, education, health promotion, and follow-up as needed for the case
Discuss possible or real cultural and socioeconomic considerations or how you would ensure equitable, inclusive care for your patient
Conclusion: Include a summary of the case study and lessons learned

Requirements:

APA 7^th edition and third person language
Include at least 4 in text citations and references
5-8 pages, not including cover page & reference page
For any medication name needs reference and intext citation
published peer-reviewed literature to support the treatment plans
primary or secondary peer-reviewed literature sources, preferably clinical practice guidelines

Title: A Comparative Analysis of Acupuncture and Pharmacotherapeutics in Managing Chronic Low Back Pain: A Case Study in a New Jersey Community Clinic

Abstract: This case study examines the treatment options for a patient experiencing chronic low back pain in a community clinic in New Jersey. The patient’s demographics, medical history, and presenting symptoms are discussed. Two evidence-based approaches, acupuncture and pharmacotherapeutics, are compared and contrasted, and the rationale behind the chosen treatment plan is explained. Additionally, cultural and socioeconomic considerations for equitable care are addressed.

Introduction

Patient Demographics: The patient in this case study is a 45-year-old male of Asian descent, residing in a low-income neighborhood in New Jersey. He presents with a chief complaint of chronic low back pain, which has persisted for six months. The pain is described as dull and aching, localized to the lumbar region, with occasional radiation to the right hip and posterior thigh. The patient reports an initial injury while lifting a heavy object at work, which triggered the pain. He has a past medical history of hypertension, for which he takes amlodipine 5 mg daily. There is no history of surgical procedures relevant to his current condition. He reports no significant family history of chronic pain conditions. Socially, he is married with two children, works as a laborer, and has limited access to healthcare due to financial constraints.

Objective Information: Upon physical examination, the patient’s lumbar spine showed tenderness over the lower lumbar paraspinal muscles. Range of motion of the lumbar spine was restricted, particularly in forward flexion. There were no neurological deficits, and straight leg raising was negative. Imaging studies revealed mild lumbar degenerative disc changes without significant pathology.

Medical Decision-Making and Clinical Impression (Diagnosis): The clinical impression for this patient is chronic low back pain, likely resulting from a combination of mechanical factors related to his occupation and degenerative changes in the lumbar spine.

Treatment Options: Two evidence-based treatment options for chronic low back pain are considered: acupuncture and pharmacotherapeutics.

Evidence-Based Treatment Options

Acupuncture: A study by Vickers et al. (2018) published in JAMA examined the effectiveness of acupuncture for chronic pain, including low back pain. The study concluded that acupuncture was associated with a significant reduction in pain intensity and improved function compared to sham acupuncture and usual care.
Pharmacotherapeutics: The American College of Physicians (ACP) Clinical Practice Guidelines (2017) recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as a first-line pharmacotherapeutic option for chronic low back pain. These guidelines also suggest considering muscle relaxants or tricyclic antidepressants in select cases.

Comparison and Contrast of Treatment Options

Acupuncture:

Non-invasive approach.
Potential psychological benefits through the placebo effect.
Long-term effects may require repeated sessions.
Cultural acceptability in some populations.

Pharmacotherapeutics:

Immediate pain relief through medication.
Can be cost-effective.
Risk of adverse effects, especially with prolonged use.
Potential for dependency on pain medications.

Analysis of Research Merit and Soundness

Both acupuncture and pharmacotherapeutics have been extensively studied in the management of chronic low back pain. The Vickers et al. study on acupuncture is well-regarded and conducted with rigor, providing robust evidence for its efficacy. However, the ACP guidelines, which recommend NSAIDs and other medications, are based on a comprehensive review of multiple studies and are widely accepted in clinical practice. The choice between the two approaches should consider the patient’s preferences and individual circumstances.

Treatment Plan and Justification

Given the patient’s socioeconomic background, limited access to healthcare, and potential cost constraints, acupuncture may not be the most feasible option. Moreover, the patient’s immediate relief needs favor pharmacotherapeutics. Therefore, the initial treatment plan includes prescribing NSAIDs for pain management, along with providing education on proper lifting techniques and exercises for lumbar strengthening. Additionally, the patient should be monitored for any adverse effects related to NSAID use.

Cultural and Socioeconomic Considerations

To ensure equitable care, it is essential to consider the patient’s cultural background, beliefs, and financial constraints. In this case, the treatment plan takes into account the patient’s potential cultural acceptance of pharmacotherapy and the need for cost-effective interventions. Communication should be culturally sensitive and include patient education materials in the patient’s preferred language.

Conclusion

This case study highlighted the management of chronic low back pain in a patient from a low-income community in New Jersey. Two evidence-based treatment options, acupuncture and pharmacotherapeutics, were compared and contrasted. Based on the patient’s socioeconomic background, immediate pain relief needs, and cultural considerations, pharmacotherapeutics, specifically NSAIDs, were chosen as the initial treatment approach. Cultural sensitivity and cost-effectiveness are crucial factors in delivering equitable care to patients in underserved communities. The patient’s progress should be closely monitored, and adjustments to the treatment plan can be made as needed. This case illustrates the importance of tailoring treatment options to individual patient needs while considering their social and cultural context.