ASSIGNMENT #2: Case Review
Bio-psycho-social Approach in Treatment of Post-traumatic Chronic Widespread Pain
April 22, 2012
This paper is about reviewing the case of Mrs. M. A.; a 53-year-old lady presented with chronic widespread pain (CWP) in spine, chest, both knees, and both shoulders in addition to generalized muscle stiffness, fatigue, headaches and dizziness. These symptoms are due to injuries sustained from a motor vehicle accident (MVA) on August 10, 2010. In the following report the result of assessment performed on April 24, 2011 will be discussed thoroughly.
Mrs. Adamian was driver of her Honda Civic in a highway on August 10, 2010 when her car was rear ended by a minivan. Her car was stopped on a ramp, where she just exited the highway. She was transported to hospital by an ambulance, and was admitted to the emergency department for six hours. She was discharged from hospital the same day and referred to her family physician for follow up. Mrs. M. A. visited her family physician 2 days after the accident complaining about severe pain and stiffness in neck, upper back, mid-back and lower back. She received prescription for pain medication and muscle relaxant, and was also referred to a rehab clinic, where she had been receiving physical therapy 3 times per week consisting of electrotherapy, massage, chiropractic care, and active rehab exercises. She is no longer receiving regular therapy as the auto insurance company stopped her coverage after 1.5 year. Her coverage for extended health is very limited and is used up after 10 treatment sessions. She still takes pain medication and performs stretching exercises at home. She reports worsening of her pain and overall condition since then.
Family, Social, and Employment History
Mrs. M. A. is a 53-year-old Lebanese woman with Armenian heritage. She was born and raised in Beirut, Lebanon, and immigrated to Canada in 1996. There are seven children in her family of origin. Her siblings reside in Lebanon, Canada and USA. Both of parents passed away; her father due to COPD and her mother due to Alzheimer disease.
Her first language is Armenian, and she speaks also Arabic, German and English. She has four good friends that she keeps in touch with but not as much as before the accident because she always feels tired. Mrs. Adamian does not smoke but consumes alcohol socially. She is divorced and lives in a 3 bedroom, 3 story townhouse with her 17-year-old son.
Mrs. Adamian reports that she had a very good relationship with her boy-friend, enjoyed his strong support, and they had plans to move in together and start a common-law relationship. However, since the accident, the relationship has been changed significantly, so that her boy-friend is not any more interested in a common-law relationship, and he prefers to continue with the current casual-relationship instead.
At the time of the accident, Mrs. M. A. was working as packer in a meat products company, 5 days per week for a total of 40 to 50 hours. She states that she did not take any time off work as a result of this accident. Her job demanded a considerable amount of standing and repetitive movement of upper extremities with some exertion and lifting from floor to waist. Since she was incapable of meeting these demands, upon request of her family physician she was put on modified duties (4 days per week for a total of 24 hours) 4 months after the accident. Her attempts to return to regular hours and regular duties at work failed, and for the last six months she has been on short-term disability (STD) with the same extended health benefit. Since her extended health coverage for rehab services is very limited, she is too worried about an ongoing litigation with the insurance company accepting to fund her health care expenses. She is also very unhappy with her current status because of the...