Question

The patient has been at the skilled nursing facility for 4 weeks and is making progress toward rehabilitation goals; however, he complains that his leg is throbbing and feels like pins and needles. As a result, he requests to rest several times during her therapy sessions. During unit rounds, his therapist inquires whether her previous pain medication should be reordered.

Pain Assessment: 4 out of 10

Current Meds: Aspirin 81 mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; gabapentin 100 mg three times daily; pantoprazole 40 mg daily, tamsulosin 0.4 mg daily, heparin 5000 units twice daily until discharged home,

• What additional recommendations would you have at this time regarding pain management?
• Are there any other therapeutic issues that should be addressed?

Answer 1

Some of the additional recommendations which could be made to manage her pain are

• Range of motion exercises(leg) which can improve her circulation in the lower limb
• Simple massage therapy, to relieve any stress in her calf muscles
• Pain management team can be involved to assess the actual cause of pain and psychological assessment of how she manages and bears the pain.
• Use of stocking or pump to prevent DVT
• Neurological assessment to identify the cause of the pain ,pains and needle sensation
• Lack of micronutrients can lead to pins and needle sensation so a nutritionist can look on it.

The therapeutic issues identified here is the medication like atorvastatin,gabapentin ,tamsulosin has a common side effects like muscle weakness and pain.