Nursing Assignment 1: Physiology, NSAIDs, Treatment of Low Back Pain

This nursing assignment explores the physiology of low back pain, focusing on the structure of the lumbar spine and the causes of disc protrusion, including poor lifting techniques and the natural deterioration of the spine. It details how disc protrusion can lead to radiating pain and potential nerve compression. The report then discusses pharmacological treatments, particularly the use of NSAIDs like ibuprofen, diclofenac, and naproxen, along with their potential side effects. It also touches on the use of acetaminophen, opioids, muscle relaxants, and injection therapies such as lumbar spinal nerve analgesia and epidural injections as alternative treatments for managing the condition. The assignment provides a comprehensive overview of the causes, mechanisms, and treatment options for low back pain, providing valuable insights into patient care and management.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the university
Author’s note

1NURSING ASSIGNMENT
1. Explain the physiology of low back pain.
The lumbar spine is a structure of bones, joints, ligaments and nerves that works together for
providing flexibility to the lower back. This spinal disc actually acts as shock absorbers between
the vertebrae supporting the upper portion of the body (Hughes et al., 2012). Central disc
protrusion is due to the natural deterioration of the lumbar spine over time. Central disc
protrusion may be caused due to poor lifting techniques (Bedbrook, 2013). The disc in the spine
is squeezed. If the pressure of the vertebrae and the disc continues then the disc may be forced to
flatten or bend forward for without impacting each other. It is evident that there had been a
central protrusion in the L3 and the L4 spinal segment of Sue. Disc protrusion is also known as
slipped disc. This occurs, when one of the discs decays and the inner gel like matrix to get
accumulated in a specific location to form a bulge or protrusion (Bedbrook, 2013). The bulging
disc expands in the center of the spinal canal where the nerve roots and the spinal cord are
located. If the protruded disc starts pressurizing any nearby nerve then radiating low back pain
might occur. Lumbar disc protrusion may lead to herniated disc (Hughes et al., 2012). A pinched
nerve in the lumbar region may lose its capability to carry the accurate neurosignals and the
wayward signals can cause various sensations in the body (Issack et al., 2012). For example a
compressed nerve can falsely signal pain. The most common type of nerve that is compressed is
the sciatic nerve, which is the longest nerve in the body. It extends from the base of the spinal
cord throughout the body. When the nerve is pinched in the beginning the pain is localized but
will eventually have radiating effect (Bedbrook, 2013).

2NURSING ASSIGNMENT
2. Discuss the pharmacological actions and effects of NSAIDS for Sue’s condition
There are a number of medications for the sciatica caused due to protruding discs. Most of the
discs are painkillers. Muscle relaxants and NSAIDs can also be taken. In order to treat Sue's
condition, the NSAIDs like Ibuprofen, diclofenac and naproxen can be taken (Pinto et al., 2012).
Care should be taken about the dosage as the NSAIDs can cause bleeding as it prevents blood
clotting. Prolonged use of the NSAIDs can cause stomach ulcers and may also attribute to
nephronal damage (Pinto et al., 2012).
Acetaminophen which is a paracetamol can also be given if inflammatory effect is seen in
Sue. If Sue is having strong pain, opoids can be given such as morphine or tramadol (Deyo et al.,
2015). Muscle relaxants can be given such as tetrazepam (Ammendolia et al., 2012). But they
can give rise to dependancy if taken for more than two week. Another approach that can be taken
to give relief to Sue is the Injection therapy; where the corticosteroids are directly injected in to
the surrounding area of the affected nerve root. It can be done in two ways. In one case the
medicine is directly injected in to the location of the nerve root. The process is known as the
lumbar spinal nerve analgesia (LSPA) (Pinto et al., 2012). In another method the medicine can
be injected in to the epidural space, which surrounds the spinal fluid and spinal cord in the spinal
canal. In lumbar epidural anesthesia the spine is monitored by a computer tomography for
making sure that the injection is administered at the right spot (Bedbrook, 2013).

3NURSING ASSIGNMENT
References
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Bedbrook, G. M. (2013). The care and management of spinal cord injuries. Springer Science &
Business Media.
Deyo, R. A., Von Korff, M., & Duhrkoop, D. (2015). Opioids for low back pain. Bmj, 350,
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Hughes, S. P. F., Freemont, A. J., Hukins, D. W. L., McGregor, A. H., & Roberts, S. (2012). The
pathogenesis of degeneration of the intervertebral disc and emerging therapies in the
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Issack, P. S., Cunningham, M. E., Pumberger, M., Hughes, A. P., & Cammisa Jr, F. P. (2012).
Degenerative lumbar spinal stenosis: evaluation and management. JAAOS-Journal of the
American Academy of Orthopaedic Surgeons, 20(8), 527-535.
Pinto, R. Z., Maher, C. G., Ferreira, M. L., Ferreira, P. H., Hancock, M., Oliveira, V. C., ... &
Koes, B. (2012). Drugs for relief of pain in patients with sciatica: systematic review and
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