I saw a 57 year old lady with PMH of HTN, chronic back pain the clinic after a fall because her foot slipped and she fell. She came in with c/o neck and low back pain.
On exam she has some tenderness along the spinal line. Rest of her exam was benign.
She was given a referral to see NSG as she mentioned that she was told at HFH ED that she had some disc bulge in the cervical area.
All through when I was assessing her she was requesting opiates. I had a long discussion with her about the pain management, I counseled her the role of physical therapy, posture, weight loss and how it can be managed without opiates and why it is not a good idea to keep taking opiates. After a lengthy and healthy discussion she agreed that she will try to manage her pain with non opiates and I gave her Tylenol.
This positive encounter with her, made me realize that if we take the time to talk to the patient about their pain issues can be managed without opiates.
From now on I will try to do in depth discussion about addressing the issue of pain and managing them without opiates.
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