Challenges and Response to Body Integrity: Healthcare Analysis

This report delves into the challenges and responses associated with body integrity, specifically focusing on the lumbar spine and its role in supporting the upper body. It discusses the mechanics of the spine, including the intervertebral disk, and how repeated stress and microtrauma can lead to conditions like lower back pain. The report also explores the use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) as a primary treatment for managing low back pain, detailing their mechanisms of action and effectiveness in reducing pain and inflammation. The report highlights the importance of understanding these physiological conditions and the therapeutic interventions used to address them, providing insights into the management of body integrity issues within a healthcare context.

Running head:CHALLENGES AND RESPONSE TO BODY INTEGRITY
Challenges and response to body integrity
Name of student:
Name of university:
Author note:

1CHALLENGES AND RESPONSE TO BODY INTEGRITY
1.
The lumbar spine is responsible for forming the caudal flexible portion of the axial
structure that supports the upper extremities, the head and the internal organs over a bipedal
stance. The sacrum is known to act as a foundation of the spine, and the lumbar spine is
responsible for supporting heavy loads in relation to the cross-sectional area. The anterior
gravitational movement is resisted through the maintenance of lordosis in a neutral position. The
lumbar spine doesnot have a lateral support and has significant mobility in coronal and sagittal
planes. The intervertebral disk has the inner nucleus pulposus and the outer annulus fibrosis
(Clarke er al., 2011). Bony projections that originate from the lumbar vertebra, including the
transverse processes and spinous processes, are responsible for maintaining ligamentous and
muscular connections to the segments below and above them (Cox, 2012).
Repeated torsional and eccentric loading in combination with recurrent microtrauma
leads to circumferential and radial tears in annular fibers. Certain tears lead to endplate
separation, causing significant loss of nuclear nutrition and hydration. The nuclear material
might migrate out of the containment due to coalescence of circumferential tears into radial tears.
Under such condition, the material enters the epidural space, leading to irritation and nerve root
compression. With decrease in disk height, the posterior articulations are forced to bear greater
percentages of the weight distribution. Under such conditions the bone growth is known to
compensate for the augmented stress for stabilizing the trijoint complex. Lower back pain is
suffered under such physiological condition. The healing process is not adequate as there is poor
supply of blood (Bauer et al., 2017).

2CHALLENGES AND RESPONSE TO BODY INTEGRITY
2.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a reputed group of therapeutic
agents that have similar mode of actions even though they have different pharmacodynamics and
structural profiles. NSAIDs are the first line of drugs for management of low back pain among
other acute or chronic conditions where the patient is suffering from inflammation and pain. The
drugs have an analgesic action that is associated with the inhibitory action of the drug on the
enzymes synthesising prostaglandins. The drugs act as inhibitor of peripheral pain as they work
through a potential analgesic pathway. Multiple mediators at the periphery trigger nociception
when there are chemical, physical or electrical stimuli. Nociceptors are sensitized by synergistic
actions of prostaglandins with other mediators. Analgesic action of NSAIDs is due to the
commotion of the process of synthesis of central prostaglandins and other modulators in the
nociceptive pathway (Takahashi et al., 2017). There also exists proof for the inhibitory impact of
the drug on prostaglandin expression in cerebrospinal fluid due to N-methyl-D-aspartate
(NMDA) receptor activation. Further, NSAIDs also has been proven to have inhibitory effect on
the lipoxygenase pathway due to the presence of algogenic metabolites whose production is
increased. The drug might interfere with G-protein-mediated signal,forming the rationale for an
analgesic mechanism where prostaglandin synthesis inhibition does not have any role (Machado
et al., 2017).
In the present case, sue has been suffering from low back pain. More precisely the
Numeric Pain Rating Scale assessment reveals that she suffers from moderate pain. The action
is supposed to occur within 24 hours. The side effects might be diarrhea, nausea, vomiting
(Enthoven et al., 2016).

3CHALLENGES AND RESPONSE TO BODY INTEGRITY

4CHALLENGES AND RESPONSE TO BODY INTEGRITY
References
Bauer, C. M., Rast, F. M., Ernst, M. J., Meichtry, A., Kool, J., Rissanen, S. M., ...&Kankaanpää,
M. (2017). The effect of muscle fatigue and low back pain on lumbar movement
variability and complexity. Journal of Electromyography and Kinesiology, 33, 94-102.
DOI: https://doi.org/10.1016/j.jelekin.2017.02.003
Clarke, C. L., Ryan, C. G., & Martin, D. J. (2011). Pain neurophysiology education for the
management of individuals with chronic low back pain: A systematic review and meta-
analysis. Manual therapy, 16(6), 544-549. DOI:
https://doi.org/10.1016/j.math.2011.05.003
Cox, J. M. (2012). Low back pain: mechanism, diagnosis and treatment. Lippincott Williams &
Wilkins.
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
Machado, G. C., Maher, C. G., Ferreira, P. H., Day, R. O., Pinheiro, M. B., & Ferreira, M. L.
(2017). Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and
meta-analysis. Annals of the rheumatic diseases, 76(7), 1269-1278. DOI:
http://dx.doi.org/10.1136/annrheumdis-2016-210597
Takahashi, N., Omata, J. I., Iwabuchi, M., Fukuda, H., &Shirado, O. (2017). Therapeutic
efficacy of nonsteroidal anti-inflammatory drug therapy versus exercise therapy in

5CHALLENGES AND RESPONSE TO BODY INTEGRITY
patients with chronic nonspecific low back pain: a prospective study. Fukushima journal
of medical science, 63(1), 8-15. DOI: https://doi.org/10.5387/fms.2016-12