Case Report: Analyzing Sam's Chronic Back Pain and Psychosocial Issues

This case report presents a detailed analysis of Sam, a 45-year-old plumber suffering from chronic back pain following a workplace injury. The report, based on a referral from his GP, explores the physical and psychosocial aspects of Sam's condition, including reduced mobility, insomnia, anger, and depression. It outlines the procedures followed, including behavioral observations and mental status assessments. The report highlights the importance of psychological factors in managing chronic pain and discusses various treatment approaches such as cognitive-behavioral therapy (CBT), mindfulness-based stress reduction, and medication. It emphasizes the need for a biopsychosocial approach, integrating psychological interventions with physical therapies. The report summarizes the negative cognitions often associated with chronic pain and recommends comprehensive treatment strategies to improve Sam's well-being and quality of life. The report also provides references to relevant research and studies supporting the findings and recommendations.

CASE REPORT
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Table of Contents
Case Report......................................................................................................................................1
Identifying information....................................................................................................................3
Reason for referral...........................................................................................................................3
Procedures........................................................................................................................................3
Background information..................................................................................................................4
Behavioral observation and mental status........................................................................................4
Test results and interpretation..........................................................................................................5
Summary and recommendation..............................................................................................6
Reference.........................................................................................................................................7
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Identifying information
Sam has been referred to a psychologist for assessment by his GP. Recently he is facing
issues because of back pain which sometime become too bad for him to bear it. After taking
treatment is not able to recover his health issues (Turner, Anderson and Cherkin, 2016).
However, back surgery was carried out shortly after the accident but he was suffering from
continuous back pain which was chronic. Some of the issues faced by Sam are reduce in
mobility, insomnia. Apart from this, some psychosocial issues faced by Sam are feels angry and
irritable most of the time. Sometime he also feels failure which makes him depressed.
Reason for referral
Sam has been referred to a psychologist for assessment by his GP, Dr Mark Thomas who
is concerned that Sam is not making a satisfactory progress with recovery from a back injury.
Reason for referring him to a psychologist is its psychosocial issues due to which his condition is
getting worst. He feels angry and irritated most of the time especially when he feels helpless.
Along with this, sometime his wife treats him like a lazy without understanding his concern and
has arguments most of the time for households and money. Hence it can be stated that Sam was
suffering from mental and physical health issues due to increase in back pain. It became
important for him that proper treatment must be provided to overcome concerns.
Procedures
There are various causes of back pain which lead to includes accidents, strains, accidents etc.
Sam was suffering from back pain as because of trying to lift a heavy pile of tiles on site. After
taking a medication he was not able to overcome his health issues (Qaseem, McLean, and
Forciea, 2017). It is important for Sam to follow systematic procedure which in overcome both
physical and mental health issues. State of mind can be affected at the time when an individual
gets low back pain better then clinical test. An individual if suffer from chronic pain or facing
issues in carrying out day-to-day activities then they may face anxiety, depression. Here,
psychological therapies such as mindfulness-based stress reduction can help in overcome the
symptom. Hence this, practice help in developing understanding to ignore negative mental
thinking and focus on breathing (Chou, Deyo. and Grusing, 2017).
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Background information
Sam is a 45 year old who lived with his wife Sarah and 3 children. He worked as a
plumber in a construction company over a year ago where he sustained a back injury after trying
to lift a heavy pile of tiles on site. Further, he was on sick leave after suffering from back injury.
He got injury on a spinal disc herniation of the lumbar region between LA and L5. Sam was also
providing back surgery but still he faces back pain which is known as chronic.
Behavioral observation and mental status
Phycological factors are rarely seemed to be essential cause of prolonged pain but it leads
to put inviably affect for worse or better. Pain which the brain thinks to important will be
amplified and those who think it is of no consequence will be lessened. Mood can directly affect
the pain and it is important to divert mind so that pain do not impact much (Cherkin, Sherman
and Turner, 2016). To live with chronic pain can enhance depression, sadness, feeling of stress
and other mental health related symptom. At the time of pain health care profession mainly refer
to the psychologist or psychiatrist. To refer to the mental health profession does not sense that
pain is in head. It leads to help in taking positive step for treating in a well manner as a whole
person through treating both the emotional and physical pain.
Psychotherapy for back pain is a drastic form of knowledge therapy which is considered for
treating severe mind, body and health condition. Psychotherapy is known as the form of
emotional theory which is driven from psychoanalysis.
Two classes of antidepressants as regularly as conceivable used to cure discouragement
in the people who experience interminable torment is specific serotonin reuptake inhibitors
(SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). For most part, embraced
SSRIs join and) sertraline (Zoloft) and fluoxetine (Prozac), however consistently suggested
SNRIs fuse duloxetine (Cymbalta) and venlafaxine (Effexor) (Ehde, Dillworth and Turner,
2014).
These medicines have been seemed, by all accounts, to be shielded and fruitful for
administering despairing with respect to endless torment, yet like all medicine, they go with
some risk of responses. Not surprisingly, make a point to discuss these pharmaceuticals in detail
with your master before beginning any treatment regimen that fuses them, and teach pro of the
impressive number of medicine (tallying over-the-counter meds), home developed cures, and
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supplements you are at the present time taking to keep up a vital separation from any negative
drug joint efforts.
Along with this medication some other types of treatments are as follows:
Talk treatment, extra properly called mental lead treatment (CBT). The point of convergence of
CBT is to empower the person to manage their situation—and may fuse attracting the patient to
change certain thought cases to an all the more elevating viewpoint, making sense of the way to
issue settle, and beating fears (McCracken and Vowles, 2014).
Work on loosening up techniques, for instance, reflection or conceivably breathing exercises.
Deliberate linking a care gathering.
Standard exercise can aid to check feelings of stress, uneasiness and downfall. Exercise
influences the body to issue endorphins, which can enhance you feel and may enable diminishing
to torment perception too (Banth, and Ardebil, 2015).
Test results and interpretation
To date, the composition shows that CBT is a capable part in the general treatment of
CLBP. As noted previously, the biopsychosocial approach to manage unending distress
organization has moved a long way from the out of date see that monotherapy is the most ideal
approach to manage achieves general remedial change.
Distinctive components - natural, mental and social - must be in the meantime tended to
and CBT serves a convincing part in dealing with the psychosocial portion of CLBP. Regardless,
it ought to be joined with other supportive sections, for instance, dynamic recovery to oversee
physical deconditioning issues.
Starting at now, be that as it may, there are no examinations particularly watching out for
what mix of fragments for what sort of unending torment issue give the best therapeutic
outcomes. Results showed this combined approach conveyed important improvements in failure,
loaded with feeling inconvenience, self-practicality and catastrophizing at whole deal
advancement. As of now, this accomplice of patients demonstrated hazardous response to both of
these treatment portions when directed alone. Regardless of the way that there were some
methodological issues related with the above examination, it outlines the creating clear need to
coordinate "fragment form" examinations of extensive torment organization programs
remembering the ultimate objective to dissect the relative duties of the diverse portions. This will
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also drive the heuristic estimation of a biopsychosocial approach to manage steady torment
organization.
It is basic to observe that CBT does not particularly address the physiological fragment of
torment. Regardless, the basic reframing of maladaptive considerations and adjusting
frameworks can incite a decreasing in a bad position, which may, consequently, reduce the
torment comprehension to some degree. Yet again, it should be seen that CBT interventions
proceed from the view that a man's understanding, evaluation, and feelings about his or her
prosperity condition and adjusting gathering, concerning torment and insufficiency, will impact
the level of excited and physical powerlessness related with the torment condition. The general
CBT system portrayed before it is used for most psychopathologies experienced (Chou, Deyo.
and Grusing, 2017). In any case, there are capabilities in the utilization of this framework that
are specific to patient's assurance. Thusly, while discussing the instrument of action for CBT one
needs to consider a bit of the more typical psychosocial decided found in Sam who suffer from
chronic pain.
Summary and recommendation
From the above report, it is summarized that patient with back pain have negative
cognitions for present, future and people around them. They started thinking that they gave
nothing to do with themselves with their pain. Due to which reason then started making wrong
assumption that pain will not go away or they think that other people not able to understand their
condition (Cherkin, Sherman and Turner, 2016). Due to this reason, they started feeling irritable,
depressed etc. It is important to provide Sam proper treatment so that it can easily overcome its
health issues. There are various psychological therapies that can be adopted so that an individual
can deal with its chronic pain and overcome health issues and pain.
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Reference
Banth, S. and Ardebil, M.D., 2015. Effectiveness of mindfulness meditation on pain and quality
of life of patients with chronic low back pain. International journal of yoga, 8(2), p.128.
Cherkin, D.C., Sherman, K.J., Balderson, B.H., Cook, A.J., Anderson, M.L., Hawkes, R.J.,
Hansen, K.E. and Turner, J.A., 2016. Effect of mindfulness-based stress reduction vs
cognitive behavioral therapy or usual care on back pain and functional limitations in adults
with chronic low back pain: a randomized clinical trial. Jama, 315(12), pp.1240-1249.
Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., Fu, R., Dana, T.,
Kraegel, P., Griffin, J. and Grusing, S., 2017. Nonpharmacologic therapies for low back
pain: a systematic review for an American College of Physicians Clinical Practice
Guideline. Annals of internal medicine, 166(7), pp.493-505.
Ehde, D.M., Dillworth, T.M. and Turner, J.A., 2014. Cognitive-behavioral therapy for
individuals with chronic pain: efficacy, innovations, and directions for research. American
Psychologist, 69(2), p.153.
McCracken, L.M. and Vowles, K.E., 2014. Acceptance and commitment therapy and
mindfulness for chronic pain: model, process, and progress. American Psychologist, 69(2),
p.178.
Qaseem, A., Wilt, T.J., McLean, R.M. and Forciea, M.A., 2017. Noninvasive treatments for
acute, subacute, and chronic low back pain: a clinical practice guideline from the American
College of Physicians. Annals of internal medicine, 166(7), pp.514-530.
Turner, J.A., Anderson, M.L., Balderson, B.H., Cook, A.J., Sherman, K.J. and Cherkin, D.C.,
2016. Mindfulness-based stress reduction and cognitive behavioral therapy for chronic low
back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in
a randomized controlled trial. Pain, 157(11), pp.2434-2444.
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