Case Study: Evidence-Based Pain Management in Osteoporosis Patients

This case study examines the application of evidence-based nursing research to the management of pain in a 70-year-old male patient with osteoporosis. The patient, who had been receiving bisphosphonates with limited success and significant side effects, is evaluated for alternative non-pharmacological treatments. The study compares the efficacy of Nuclear Magnetic Resonance Therapy (NMRT) and exercise programs against traditional medical therapy. The analysis includes summaries and appraisals of two key articles: one focusing on NMRT's positive effects on bone density and pain reduction, and another recommending exercise and lifestyle modifications for managing osteoporosis. The clinical bottom line suggests that NMRT may offer advantages over bisphosphonates by increasing bone density and reducing pain without the severe side effects. However, both NMRT and exercise have implications for practice, including considerations of cost, patient compliance, and potential risks. The case study concludes by emphasizing the need for further research to fully understand the benefits and drawbacks of these different approaches to osteoporosis pain management. Desklib provides access to similar case studies and resources for students.

Running head: EVIDENCE-BASED NURSING RESEARCH 1
Evidence-Based Nursing Research
Name
Institution

EVIDENCE-BASED NURSING RESEARCH 2
NON-PHARMACOLOGICAL: THERAPIES IN PAIN MANAGEMENT FOR A
PATIENT WITH OSTEOPOROSIS
Clinic Scenario
A seventy-year-old man came to the hospital with osteoporosis disease. He had been
receiving treatment/ medical therapy using the drug bisphosphonates. The drug had very harmful
side effects such as kidney diseases for quite a while. However, there was no improvement in his
body at all. The drug added to him having many other side effects then the doctors decided to
use the nuclear magnetic resonance on bone mineral density if this would benefit his disease and
have an improvement in his health.
PICO Question:
Inpatient with osteoporosis does treatment with nuclear magnetic resonance help in pain
management or the use of exercise program compared to therapy with medical therapy using the
bisphosphonates, raloxifene, and osteoporosis in patients with osteoporosis.
Articles:
 Krpan, D., Stritzinger, B., LUKENDA, I. L., Overbeck, J., & Kullich, W. (2015). Non-
pharmacological treatment of osteoporosis with Nuclear Magnetic Resonance Therapy
(NMR-Therapy). Periodicum biologorum, 117(1), 161-165.
 Jeremiah, M. P., Unwin, B. K., Greenawald, M. H., & Casiano, V. E. (2015). Diagnosis
and management of osteoporosis. Am Fam Physician, 92(4), 261-268.
Summary and Appraisal of Key Evidence of Krpan et al. (2015) Article

EVIDENCE-BASED NURSING RESEARCH 3
The study was done by Krpan et al. (2015) for a total of 103 patients aged 45 and 99
years with a mean age of 66years who had osteoporosis with a T-score mineral density less
than-2.5 were included in the trial. All these patients had been taking the bisphosphonates
medicine for almost a year, and there was no improvement. All these patients received
osteoporosis treatments with low field nuclear magnetic resonance using a special NMR device.
For one hour a day which was to take place for ten consecutive days. After the 12 month
treatment, there was an increased improvement for those patients as compared to supplement to
medical therapy in patients with osteoporosis.
The bone is very metabolically active and constantly needs repair and to be remodeled to
function very well but the osteoporosis diseases have become a threat especially to the old
people and are causing many side effects to them. This disease can be prevented and also treated
the only problem is that it is underestimated, underdiagnosed and also undertreated. The medical
therapy used bisphosphonate as medical therapy had many effects which led to the emergence of
the new NMRT system which would lead to an improvement of the treatment (Krpan,
Stritzinger, Lukenda, Overbeck & Kullich, 2015).
This method can provoke positive effects on the bone cells and improve the function and
movement and also reduce the pain that one was experiencing. This NMRT system uses a
technology that will activate the cellular metabolism and regenerative processes and will bring
about the pain relief in degenerative rheumatic diseases. To show the effect of this method we
use two parameters that are the bone density and the marker for a born turnover. Where the
accuracy of bone.
This NMR measurement brought about the improvement of the T-score on the umbra
vertebrae hence there was an increase in the bone density and also led to the improvement of the

EVIDENCE-BASED NURSING RESEARCH 4
serum level of the born turnover in the 12 months of the treatment and also the bone formation of
the parameter osteocalcin increased also. These small changes led to unaltered bone
degeneration. Using this NMR device using this electromagnetic fields this could lead to
promote osteogenesis, which activates the metabolic processes and regenerates in selecting the
cellular tissues.
Summary and Appraisal of Key Evidence of Jeremiah et al. (2015)
The systematic review done by Jeremiah, Unwin, Groenewald and Casino in 2015 them
they recommended exercise exerciser physical therapy and vitamin D supplementation to
patients whose age are 65 years and above with the osteoporosis disease because they believed it
was related by fracture risk but not the BMD risk (Jeremiah, Unwin, Greenawald & Casiano,
2015). This exercise includes weight-bearing resistance and balance training that should be
highly recommended. This exercise should be the ones that don’t incorporate a lot of strength
and also the balance training that this will decrease the pains. this patients were also discouraged
from alcohol drinking and smoking since these will decrease the BMD to all the skeletal sites,
also their diets are modified where they should reduce the amount of caffeine they consume and
take food rich in proteins this could either be animal or plant protein and also these diet should
contain vitamin D, calcium, vegetable and fruits this is likely to optimize bone health
Clinical Bottom Line
The use of NMR was Avery important fact since would increase the bone density as well
as reduce the rate of pain in the areas affected this method was the best since using the medical
therapy which included the use of bisphosphonates ,reloxifenes, calcitonin, terriparatide and
denosumab had a lot of side effects such as the increase rate of breast cancer and causing kidney
diseases that will affect the patient despite him treating osteoporosis it leads him to getting other

EVIDENCE-BASED NURSING RESEARCH 5
disease that are very vulnerable’ another good advantage of using the NMR system it doesn’t
lead to bone loss but increases its density and also the turnover reducing to the pain. Using the
aerobic system was also effective but the problem is it would take many years for one to realize
the changes hence most patients would give up. We need more information of using these two
methods and how will one benefit from them and also the cost of using these two methods
Implications for Practice
This two methods have their own benefits but also their implications, the aerobic method
that do not incorporate strength and balance causes high risk to the fracture and also the risk
factor of patients falling and mitigation will prevent from the treatment while the NRM systems
kneads to proliferations, apoptosis and visibility of human rocytes and osteoblasts due to the
continuous use of the excess use of the rays for treatment and they are likely also to resist
treatment and also its an expensive way to all the [patient and the risk factors to people below 65
years is very adamant as compared to those above 65.and the old people cannot manage these
human therapy by aerobics.

EVIDENCE-BASED NURSING RESEARCH 6
References
Jeremiah, M. P., Unwin, B. K., Greenawald, M. H., & Casiano, V. E. (2015). Diagnosis and
management of osteoporosis. Am Fam Physician, 92(4), 261-268.
Krpan, D., Stritzinger, B., Lukenda, I. L., Overbeck, J., & Kullich, W. (2015). Non-
pharmacological treatment of osteoporosis with Nuclear Magnetic Resonance Therapy
(NMR-Therapy). Periodicum biologorum, 117(1), 161-165.