Does your pain worsen with movement?

 

Emil says, "Come to think of it now, it does."

Learning Point: Pain worsening with movement is a feature of INCIDENTAL pain. This is a key feature of bony metastases in the spine, pelvis or femora. Bony metastases cause a type of SOMATIC pain characterized as gnawing, aching, well localized and occasionally cramping. This is compared to VISCERAL pain which is a more poorly localized, squeezing, aching type such as pain from liver metastases.

From: "Alberta Cancer Board:Alberta Palliative Care Resource 2nd ed. 2001"

History of Present Illness
What else would you like to ask Emil about his new back pain?
Physical Examination
How is the pain affecting your daily functioning?
Back to the key question for determining incidental pain.
How would you investigate this type of pain?

  • Reason for VIsit
  • History of Present Illness
  • Past Medical History
  • Social History
  • Physical Examination
  • Family History
  • Cancer Pain Management
  • The Last Days
  • Case Learning Objectives
  • References
  • Investigations
Map: Emil, Palliative Care_2 (2200)
Node: 44985
Score:

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OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • Stage 1
  • Xray thoracic/lumbar spine.
  • chest x-ray
  • Prostaglandin
  • Send to hospital
  • What opioid would you start a patient who has never been on opioids before?
  • Does your pain worsen with movement?

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