An Effective Patient-Centered Approach to Chronic Pain: A Case Report
Background: Chronic pain is a highly prevalent chronic condition in Canadians, which is arduous to treat and leads to a multitude of chronic comorbidities if treated sub-optimally. We aim to provide an example of evidence-based inter-disciplinary by following the treatment course in a successfully treated 28-year old female with 9-year history of chronic neck and back pain, without adequate pain control through multiple treatment modalities.
Case: The patient developed constant neck pain and back pain with debilitating headaches and mood disorder after a motor vehicle accident. Subsequent therapy included a wide variety of medical interventions, manual therapies, and counselling, while using emergency room visits for pain flare-ups, all without sustained benefit. The patient underwent myofascial trigger point injections targeting previously identified myofascial pain, then diagnostic ultrasound-guided medial branch blocks, followed by prolotherapy while awaiting referral to radiofrequency ablation of affected sites. Simultaneously, she joined in-clinic group education programs aimed at self-management of headaches, psychogenic response to pain, and sleep, as well as counselling for behaviour modification, diet planning, and functional movement rehabilitation by multiple health practitioners.
Results: Patient noted progressive improvement after initiation of treatment; 12 months after the initial visit she noted substantial improvements in pain severity and interference, ability and confidence in coping with pain, and depressive symptoms.
Conclusions: This case report documents a successfully managed case of chronic neck and back pain by augmenting the ongoing procedures with patient education and programs which address other crucial components of pain control such as sleep, nutrition, and behaviour management.