Question

Identify a family member or a friend, not a client, and conduct a pain assessment using the COLDERR approach/questions. Write a brief summary of what you found and identify two nursing non-pharmacological interventions that you might recommend.

Answer 1

COLDERR Pain Assessment:

COLDERR stands for

C: Characteristics

O: Onset

L: Location

D: Duration

E: Exacerbation

R: Radiation

R: Relief

For this COLDERR pain assessment I was assessed my close friend who was suffering with chronic pain. She stated that the pain in both knees feels like someone is either constantly sitting on them causing a stiff, ache like pain, otherwise it sometimes feels like someone took a hammer to my knees and it is a throbbing pain with some burning. The pain for her started shortly after injuring both knees within a year of each other while playing college volleyball. She tore her ACL, meniscus and LCL in her left knee and then nine months later tore her meniscus, MCL and PCL in her right knee. I had her point to where her pain is primarily located at the anterior surface of both her left and right knee.

The duration of her pain fluctuates, especially during the winter months. In most cases the pain lasts all day until she falls asleep because once she’s asleep she no longer notices the pain. Strenuous activity is what makes the pain worse for her, however, she works out several times a week and still does physical therapy on her own as often as she can. Alternating acetaminophen and ibuprofen tends to make the pain better, but only for a short period of time. Her pain tends to stay located at her knees, but there have been a few instances where the pain has travelled down to her calves and to her feet. However, that only happens if she really pushes herself while doing workouts.

One non-pharmacological intervention I would suggest is the use of hot/cold compress therapy as well as contrast therapy. The benefits of thermal therapy include the benefits of improving range of motion, an increase in circulation or blood flow, transient reduction of joint stiffness and pain/muscle spasms. Heat therapies also reduce the inflammation and congestion of the tissues in the surrounding area (Denegar et al, 2016). The benefits of cold therapy is that is reduces the metabolic rate, inflammation, circulation and muscle spasms related to pain. Vasoconstriction of the blood vessels causes a reduction of blood volume to the site of the injury which results in reduced swelling and pain management. Heat and cold therapy when used in contrast are believed to exert and physiological effect on an individual’s pain gate mechanism. It temporarily alters the pain signals which reduces pain and allows for relief for those who suffer long term pain (Denegar et al, 2016).

The second form of non pharmacologic intervention I would suggest to her would be taping the kneecap with kinesio tape as needed and while working out or doing physical therapy. Kinesio tape is a taping technique designed to facilitate the natural healing process all while providing support and stability to the muscles and joints where the tape is administered. It doesn’t restrict the body’s range of motion like a brace and it provides extended soft tissue manipulation which prolongs the benefits of manual therapy (Homayouni et al, 2016). I would recommend both of these form of interventions because they are non-prescription methods that have proven benefits to the body. They are alternative methods to help alleviate pain and are methods that can be done multiple times a day.

References:

Denegar, C., Saliba, E., &Saliba, S. (2016). Therapeutic Modalities for Musculoskeletal Injuries, 4th Edition.Medicine & Science in Sports & Exercise, 48(9), 1856.        doi:10.1249/mss.0000000000001058

Homayouni, K., Foruzi, S., &Kalhori, F. (2016). Effects of kinesiotaping versus non-steroidal       anti-inflammatory drugs and physical therapy for treatment of pes anserinustendino-   bursitis: A randomized comparative clinical trial. The Physician and Sportsmedicine,    44(3), 252-256. doi:10.1080/00913847.2016.1199251

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