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1 Pain Disorder Case Study Audrey Barron Master of Science in Nursing, Walden University NURS-6521: Advanced Pharmacology Dr. Cynthia Uche January 24, 2021
2 Pain Disorder Case Study Pain disorders is a somatoform disorder, this is where a person experiences chronic pain that can be in one or more areas and is thought to be caused by psychological stress (AllAboutCounseling.com, n.d.). Pain disorders can be characterized by acute or chronic pain that have physical symptoms but have no explained origin and has no link to another physical illness or substance abuse. Pain disorders are more commonly experienced in women then men and the onset of age can vary. Treatment of pain disorders vary but consist of treating both the physical pain and the psychological problems. Background This week our class was given a case study to review which included treatment options for a patient who is experiencing a pain disorder. We were asked to briefly summarize the patient case study along with the three decisions that was taken for the patient’s treatment. We were also to ask ourselves that based on the decisions we had recommended for the patient whether we believed the decisions provided were supported by the evidence-based literature, what were hoping to achieve with the decisions we recommended, and to explain any differences between what we expected to achieve with each decision and the results of the decision of the exercise. Case Study A 43-year-old male presents to the office with a chief complaint of pain. The patient is ambulating with the assistance of crutches and reports that his family physician sent him to have a psychiatric assessment because the doctor thinks that the pain is “all in his head” and that the physician believes the patient is only trying to get “narcotics to get high”. Patient reports chronic pain for 7 years since falling at work. Numerous diagnostic tests were completed on right hip in the past, he reports 4 years ago that they discovered that his cartilage surrounding the right hip joint was 75% torn (from the 3 o’clock to the 12 o’clock position). Patient reports that do to his
3 age no surgeon he saw wanted to do a total hip replacement and believed the tissue would repair itself over time. He reports that he experiences cooling and cramping of the extremity. He also states that he was diagnosed by a neurologist to have complex regional pain syndrome (CRPS) or also known as reflex sympathetic dystrophy (RSD). He was referred back to his family physician who states that RSD does not exist and that it comes from depression. Since his injury the patient reports that his fiancé left him and that occasionally he does get “down in the dumps” occasionally but denies depression. During the patient’s assessment the patient states “oh! It’s happening, let me show you!” Upon exam patient right leg is noted to be turning purple from the knee down and his foot is noted to in a visible cramp where the toes are curled inward and the foot is folding inward. After

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