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There are numerous causes of chronic pain and these including different underlying chronic pathologies such as congenital abnormalities in the structure of the spinal cord, trauma, obesity, ageing and other underlying conditions such as multiple sclerosis, AIDS and cancer.
When carrying out an assessment of an individual with chronic pain, there are several issues which have to be addressed; however, among these issues there are three main questions that are important for the physician. The first question is the extent of the disease affecting the patient; the magnitude of the disease in terms of suffering and pain and how these intrude into the everyday life of the patient; and finally, whether the complaints of the patient are in coherence with the disease or if there are some signs of exaggeration indicating a psychological component to the condition of the patient.
There two patients that were examined and one was a 45 year old male with a history of brachial plexus injury and the other a 75 year old woman suffering from tendonitis. The 45 year old male complains of pain that has lasted for approximately a year. The patient complains of pain that is associated with a tingling sensation in the form of an electric shock. Upon examination, the patient displays weakness in the arm and he also says he feels numbness in his right arm. The 75 year old woman has a history of tendonitis which is approximately 25 years. The patient reports pain that is predominantly in her wrist area and there is also significant swelling in the wrist area. Upon examination, the patient was found to have swelling at the area of the thumb and was diagnosed with DeQuervain’ tenosynovitis. The patients both went through a psychological examination and this indicated that there was no exaggeration of pain among these patients and it was in coherence to the medical conditions which they were found to have.
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