University Assignment: Challenge and Response to Body Integrity

This report delves into the challenge and response to body integrity, specifically focusing on the physiology of low back pain. It explores the role of nociceptors in transmitting pain signals from tissue injury to the brain, detailing the process of transduction, conduction, transmission, and spinal modulation. The report examines common causes of low back pain, such as herniated discs and lumbar spinal stenosis, and the degenerative cascade associated with these conditions. Furthermore, it analyzes the pharmacological actions and effects of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), explaining their mechanism of action by inhibiting Cyclooxygenase (COX) enzymes, thereby reducing prostaglandin synthesis and inflammation. The report discusses the benefits of NSAIDs in managing pain and stiffness, while also addressing potential side effects and considerations for patients with pre-existing conditions, like alcohol use. The provided references support the scientific basis of the information presented.

Running head: CHALLENGE AND RESPONSE TO BODY INTEGRITY
Challenge and response to body integrity
Name of the Student
Name of the University
Author note

1CHALLENGE AND RESPONSE TO BODY INTEGRITY
Physiology of low back pain
Sue has lower back pain as consequence of the physical demands of Fire and Rescue
Service. Nocireceptors are common cause of pain radiating in back from the place of tissue
injury, via transmission of impulse from place of tissue injury. It is the physiologic response
of the body. The neuron makes connections in both spinal cord and brain and alerts us of
damaging stimuli (via transduction, conduction, and transmission) followed by spinal
modulation, and relay the message to higher brain centres via electrical signals. These signals
are interpreted as pain by brain (CNS) and leads to supraspinal responses. The pain may
commonly arise from the herniated disc, which is the cause of the pain due to unwanted
contact between the nerve and the disc (Craft et al., 2015, pp.137-153). Lifting heavy materials
increases the stress on the disc. Back pain is developed when the disc is herniated and some of
the inner fluid is leaked (Parker et al., 2015). It is the wear and tear process of the disc may
occur in lumbar spine resulting protrusion against spinal nerve root. This process is known as
degenerative cascade (Bhalla et al., 2016). The other possible reason may be the lumbar spinal
stenosis. It occurs due to enlargement of the facet joints of the segment. The condition causes
compression of the spinal nerve roots and is due to degenerative conditions such as
spondylolisthesis and osteoarthritis, where the pain radiates from the lower back to the legs
(Tobert & Harris, 2018).
Pharmacological actions and effects of NSAIDS for Sue’s condition
NSAIDS are popularly used for the pain management. NSAIDS exhibit their
pharmacological action by inhibiting the Cyclooxygenase (COX), which in turn inhibits the
synthesis of the prostaglandin and other eicosanoid. COX1 play role of housekeeping and

2CHALLENGE AND RESPONSE TO BODY INTEGRITY
regulates normal cellular process (protects kidney and stomach platelet aggregation). COX2 is
responsible for the increased Prostanoid production during inflammation (via cytokines). They
play a dominant role in the inflammation and cancer. It contributes to pain and swelling of
inflammation. Prostaglandins are consistently expressed in bones, kidney, brain and results in
inflammation when expressed at other sites (Bryant & Knights, 2014, pp. 319 - 339).
Consequently the homeostatic mechanism is disrupted with NSAIDS. In Sue, the NSAIDS will
help lower the pain caused in lumbar spine. Arachdoinic acid is central to this pathway of
NSAIDS that exhibits anti-inflammatory effect at the site of injury of pain (lower back pain in
case of Sue). Inflammation results in vasodilatation extravasation of protein exudates and
nociception. In this process prostaglandins are key players in this process and are thus inhibited
during lower back pain (Enthoven et al., 2016). Therefore NSAIDS lower pain and
inflammation in lower back pain when administered to Sue. It is useful for reducing stiffness in
Sue. NSAIDS are administered in dose dependent manner. Higher dose is effective for the
higher degree of swelling, stiffness and pain. The therapeutic and toxic effects vary in different
drugs. The side effects may include kidney damage. Liver damage is found in patients with
alcohol use, when administered with acetaminophen. It might be risk for Sue as takes alcohol
and is recommended to take for short period of time (Schilling, 2016).

3CHALLENGE AND RESPONSE TO BODY INTEGRITY
References
Bhalla, A., Schoenfeld, A. J., George, J., & Bono, C. M. (2016). The Influence of Sub-Diagnosis
on Radiographic and Clinical Outcomes after Lumbar Fusion for Degenerative Disc
Disorders: a 15-Year Meta-Analysis. The Spine Journal, 16(10), S366.
DOI: https://doi.org/10.1016/j.spinee.2016.07.493
Bryant, Bronwen & Knights, Kathleen, (author.) (2015). Pharmacology for health
professionals (Fourth edition). Chatswood, New South Wales Mosby. isbn=978-0-7295-
8171-4
Craft, J., Gordon, C., Huether, S. E., McCance, K. L., & Brashers, V. L. (2015). Understanding
pathophysiology-ANZ adaptation. Elsevier Health Sciences. ISBN : 9780729541602
Enthoven, W., Roelofs, P. D., Deyo, R. A., van Tulder, M. W., & Koes, B. W. (2016). Non‐
steroidal anti‐inflammatory drugs for chronic low back pain. The Cochrane Library.
DOI: 10.1002/14651858.CD012087
Parker, S. L., Mendenhall, S. K., Godil, S. S., Sivasubramanian, P., Cahill, K., Ziewacz, J., &
McGirt, M. J. (2015). Incidence of low back pain after lumbar discectomy for herniated
disc and its effect on patient-reported outcomes. Clinical Orthopaedics and Related
Research®, 473(6), 1988-1999. DOI: https://doi.org/10.1007/s11999-015-4193-1
Schilling, R. (2016). Pain Treatment. Pain. Retrieved from: http://www.askdrray.com/pain-
treatment/

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Tobert, D. G., & Harris, M. B. (2018). Degenerative Lumbar Spinal Stenosis and
Spondylolisthesis. In Principles of Orthopedic Practice for Primary Care Providers (pp.
47-59). Springer, Cham. DOI: https://doi.org/10.1007/978-3-319-68661-5_4

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Appendix
Pain pathway