Case Study Report: David's Back Pain, NSAIDs, and Analgesics

This case study report centers on David, a 71-year-old man suffering from lower back pain. The report investigates the pathophysiology of his pain, which initially presented with acute tenderness and later revealed metastatic lesions via MRI. It examines the effectiveness of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) for pain management in older adults, highlighting their mechanism of action and common usage. The report also addresses the appropriate analgesics to prescribe David following the MRI findings and persistent pain, considering the potential for steroid use and palliative treatment options like radiation therapy and surgery. The report concludes by emphasizing the use of NSAIDs in treating older people and the further path to reduce the pain.

CASE STUDY
REPORT

Table of Contents
INTRODUCTION...........................................................................................................................3
1.Explain the pathophysiology of David’s lower back pain.......................................................3
2a.Discuss the effectiveness of NSAIDS for pain management in older people........................3
2b.Following the MRI report, and the pain being persistent, which analgesics should be
prescribed to Mr David?..............................................................................................................4
CONCLUSION................................................................................................................................4
REFRENCE ....................................................................................................................................5

INTRODUCTION
This report comprises of case study which revolves around David a 71 year old man who is
facing pain in the lower back. This report also answers various question such as effectiveness of
the use of NSAIDs in order to deal with the pain.
1.Explain the pathophysiology of David’s lower back pain.
David lower pain was getting severe gradually for the past 2 months. Although he was
exercising on a regular basis still the pain was getting more serious. There was no clinical signal
Until he opted for physical examination where it showed that there was acute tenderness over
T12-L1. He was instructed to get a Magnetic resonance imaging and a non steroidal anti
inflammatory medication when he feel pain again (McCartney and Nelligan, 2014). After a
week later he had to see his general practitioner again because of the pain as the pain was getting
worse and report received by GP depicted metastatic lesions in thoracic and lumbar vertebrae.
The clinical made a call to David insisting him to get immediate consultation (Roubille and et.
al., 2015).
2a.Discuss the effectiveness of NSAIDS for pain management in older people.
Nonsteroidal anti-inflammatory drugs are among the most widely used medications in the
world that is because of their demonstrated efficiency in reducing the pain (Rzewuska and et.
al., 2015). Elderly people comprises the fastest growing segment of the world they commonly
face pain in joints and back Where as Non steroidal anti-inflammatory drugs are among the most
common pain relief medicine in the globe (Savvas and Gibson, 2015). It is being used in order to
soothe headaches, sprains, arthritis symptoms and daily discomforts which arises because of the
pain. NSAID is effectively recommanded by doctors in order treat the pain faced by older
people because of the integrated role of COX pathway in the generation of inflammation and in
the biochemical recognition of pain. NSAIDs work on a chemical level. They block the effect of
special enzymes such as Cox-1 and Cox-2 enzymes. These play an important role in making
prostaglandins. By this it blocks the Cox enzymes which stops body from making as many
prostaglandins. Which further results in less swelling and pain.

2b.Following the MRI report, and the pain being persistent, which analgesics should be
prescribed to Mr David?
The MRI report showed that the pain is persistent which required him to consult GP as
soon as possible. General practitioner can use steroid in treatment of the same as both steroid and
NSAID are being used in the treatment of the pain. Further the treatment regimen for spinal
metastasis is generally palliative and consists of a combination of medical therapy (steroids, pain
medication, and chemotherapy), radiation therapy, and surgery (Wehling, 2014).
CONCLUSION
From this report the use of NSAIDs in treatment of disease of older people can be
analysed and it's effectiveness can be studied. Further the report deals with the further path can
be used in order to reduce pain.

REFRENCE
Books and Journals
Altman and et. al., (2015). Advances in NSAID development: evolution of diclofenac products
using pharmaceutical technology. Drugs.75(8). 859-877.
Buer, J. K. (2014). Origins and impact of the term ‘NSAID’. Inflammopharmacology. 22(5).
263-267.
McCartney, C. J., & Nelligan, K. (2014). Postoperative pain management after total knee
arthroplasty in elderly patients: treatment options. Drugs & aging.31(2). 83-91.
Roubille and et. al., (2015). The effects of tumour necrosis factor inhibitors, methotrexate, non-
steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in
rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-
analysis. Annals of the rheumatic diseases.74(3). 480-489.
Rzewuska and et. al., (2015). The efficacy of conservative treatment of osteoporotic compression
fractures on acute pain relief: a systematic review with meta-analysis. European Spine
Journal.24(4). 702-714.
Savvas, S., & Gibson, S. (2015). Pain management in residential aged care facilities. Australian
family physician.44(4). 198.
Scheiman, J. M. (2016). NSAID-induced Gastrointestinal Injury. Journal of clinical
gastroenterology.50(1). 5-10.
Wehling, M. (2014). Non-steroidal anti-inflammatory drug use in chronic pain conditions with
special emphasis on the elderly and patients with relevant comorbidities: management
and mitigation of risks and adverse effects. European journal of clinical
pharmacology.70(10). 1159-1172.