Question

Case Study Progress All serious medical conditions are ruled out, and J.C. is diagnosed with lumbar strain. The midlevel provider orders a physical therapy consult to develop a home stretching and back- strengthening exercise program and a dietary consult for weight reduction. J.C. is given prescriptions for cyclotenzaprine (Flexeril) 10 mg tid prn x 3 days only and naproxen 500 mg twice daily for one month. He receives the following instructions: Ice packs to the lower back for 20 minutes every hour, no twisting or unnecessary bending, and no lifting more than 10 pounds. J.C: is instructed to rest his back for 1 or 2 days, getting up only now and then to move around to relieve muscle spasms in his back and strengthen his back muscles. He is given and excuse to stay off work for 5 days, and he is instructed to return to the ED if he gets worse.

Answer 1

Question no 5)

Naproxen is a drug which is having high level of anti inflammatory property as well as a non opioid analgesics.

Nonsteroidal anti-inflammatory medications are used for the reduction of inflammation and to relieve pain that occur as a result of lumbar strain. These include naproxen and variety of prescription drugs. ... Other medications are available that also have an anti-inflammatory effect.

The results of some study reveals that patients with lumbar strain with acute low back strain benefit from the use of both NSAID(naproxen) and a muscle relaxer  (cyclobenzaprine).

Tylenol lack anti inflammatory property .

Question no 6)

Points to be included while teaching on muscle relaxants.

• These  medicines can cause drowsiness in patients
• If you feel drowsy when taking these medicines, do not drink alcohol or drive or operate machinery
• It should not be stopped suddenly
• Make sure that addiction don't take place

Side effects of muscle relaxants

• Tiredness
• Drowsiness
• Sedation effect
• Fatigue or weakness
• Dizziness
• Dry mouth
• Depression
• Decreased BP

Abuse and addiction to muscle relaxants should be stopped

Question no 7

Exercise to promote back health

Pelvic tilt exercise and lower back rotating stretches

Question no 8

Cyclobenzaprine is a muscle relaxant used along rest and physical therapy for relief from muscle spasms associated with acute painful skeletal muscle conditions and lumbar strains . Naproxen is used to relieve mild to moderate pain, fever and inflammation from various causes.

patients with lumbar strain along acute low back strain get relived from the use of both NSAID( naproxen) and a muscle relaxant (cyclobenzaprine).

So this combination in J.C can bring about great reduction in back pain and provide relaxation

Question no 9

NSAID was used in Mr JC because it helps in reducing inflammation of the lumbar region and well as is a good non opioid analgesics when compared to acetaminophen

Question no 10

• Risk for Ineffective Breathing Pattern
• Risk for Trauma related to further strain
• Impaired Physical Mobility related to lumbar strain
• Acute pain related to lumbar strain