Reference no: EM132274108 , Length: word count:400
Case Study -
David, a 71-year-old man, who owns a small business present to his GP with lower back pain. He is generally active, walking and cycling regularly but his lower back pain is starting to restrict these activities lately.
Upon questioning, David related that the lower pain has been there for the last 2monthsand has gradually become more severe. On physical examination, there was acute tenderness over T12-L1. There were no other clinical signs. The GP was unsure of the origin of the lower back pain and David was instructed to have magnetic resonance imaging (MRI)of the spine and prescribed a non-steroidal anti-inflammatory medication to be taken when he experiences pain. David saw his GP one week later and complained of worsening pain. GP added another NSAID to David's prescription.
Four weeks later MRI scan was done, and report which was sent to GP clinic showed metastatic lesions in thoracic and lumbar vertebrae. The GP clinic called David to come for an immediate consultation.
Answer the following TWO questions:
1. Explain the pathophysiology of David's lower back pain. (150 words approx.)
2a. Discuss the effectiveness of NSAIDS for pain management in older people.
2b. Following the MRI report, and the pain being persistent, which analgesics should be prescribed to Mr David? (250 words approx.).
Note - 400 words and please use APA referencing style.