Mr Jones Persistent Pain Case Study
Presenting Condition[edit | edit source]
Mr Jones is a 45 year old male who has persistent low back pain for 5 years.
He reports:
- Pain radiating from the centre of his spine up to mid thoracic spine VAS 6-7/10 constantly
- The pain intermittently radiates down both buttocks into mid posterior and anterior thighs VAS 8/10
- Sleep disturbed total of 4-5 hours on a good night. Takes an hour nap after work.
Aggravating factors:
- Walking more 10 minutes
- Sitting more 30 minutes
- Lumbar flexion and extension
- Driving longer than 20 minutes
- Lifting and carrying any weight
- Having sex
Easing factors:
- Side lying
- Intermittent walking / sitting
- Taking medication
24 Hour Pattern
Am-
Wakes up pain 7/10 takes him a while to get going, takes his pain killers and allows him to get ready doesn't eat breakfast everymorning as it is difficult to to face due to the pain
Goes to work by car 30 minute drive and parks next to the office door pain is aggravated again 6/10 due to the drive.
Sits at his desk all morning taking 1 coffee break. He moves around in his chair as he is uncomfortable, and finds it difficult to concentrate and focus on his work due to the pain and the pain medication.
PM
He has his lunch from the canteen which is a 3 minute walk away and sits with his colleagues for 25 minutes before returning to his desk. Pain is 7/10 normally.
He spends the rest of the afternoon either at his desk, on the phone to clients or in meetings with project teams and management.
He finishes work and drives home, by this point he is 8-9/10 VAS
He then spends 1-1.5 hours in bed as he is exhausted by the pain and hasn't slept well. He also finds that the medication make him feel sleepy.
His wife cooks dinner and they have together as a family. He then spends the rest of the evening watching television. He finished his evening off by having a cup of tea and checking social media on his phone in bed before he goes to sleep.
He wakes up at 2 - 3am most nights and gets up and sometimes goes on the internet or goes downstairs. He usually gets back to sleep for another couple of hours and gets up at 7am for work.
On a weekend he spends 2 hours napping and tends to stay in and around the house. His wife does the shopping, cooking and cleaning (she also works full time), as these tasks flare up Mr Jone's pain.
