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Question: A 35-year-old male was admitted to the hospital. The admitting diagnosis documented on the history and physical examination report was "chronic pain syndrome and chronic lower back pain with exacerbation of lower back pain and lower extremity pain." Also included in the patient's history is the fact that the patient was injured in a serious motor vehicle crash three years ago and has had back pain ever since that injury. However, the patient's pain has increased over the past three months and has become excruciating over the past week. The patient was admitted to the hospital specifically for pain management. The patient received intravenous and intramuscular pain medications as well as a peripheral nerve block to manage his pain, which he reported as much improved at the time of discharge. The peripheral nerve block involved percutaneous injection of a regional anesthetic. The final diagnosis written by the physician was acute exacerbation of chronic pain syndrome, chronic lower back pain, and lower extremity pain, both right and left legs. The physician also wrote that the pain was likely the consequence of sympathetic lumbar spinal nerve root damage from the injuries sustained in the motor vehicle crash.
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