Betty Jones is a happily married 54 y/o primary school teacher who presented at our clinic with a 2-day history of intense back pain after moving a heavy pot in the garden and a long-term history of bronchitis. Her back pain is exacerbated by a current episode of bronchitis, which is maintained by smoking 3-5 cigarettes daily.
While in the garden two days ago, Betty bent over to move a large ceramic flower pot. Upon lifting, she experienced immediate pain which has remained consistent with an intensity of 7/10. Slight relief was found only by taking nurofen and the application of a heat pack. This pain is a 5/10 with pain relief and an 9/10 at worst with coughing and exertion. Betty reports the pain as being just lateral to her spine on the left (motions around levels T3/4) and localised to a specific location. She describes the pain as sharp, especially on inhalation. It does not radiate at any time. Betty’s pain is constant, but slightly varies in intensity throughout the day without pattern. …show more content…
This current episode has been preceded by 3 previous attacks of bronchitis in the past 20 months. Each episode has lasted between 2 and 4 months and brings about intense fits of coughing with dyspnoea and wheezing. Betty insisted that it is normal for her to ‘have a round of heavy coughing’ every few months and attributes it to the season changing. Coughing fits occur at least once a day and require Betty to rest from whatever she is doing until the coughing fit ceases. This current episode of coughing is her worst to date. She smokes roughly 3-5 cigarettes a day and finds this makes her cough
While in the garden two days ago, Betty bent over to move a large ceramic flower pot. Upon lifting, she experienced immediate pain which has remained consistent with an intensity of 7/10. Slight relief was found only by taking nurofen and the application of a heat pack. This pain is a 5/10 with pain relief and an 9/10 at worst with coughing and exertion. Betty reports the pain as being just lateral to her spine on the left (motions around levels T3/4) and localised to a specific location. She describes the pain as sharp, especially on inhalation. It does not radiate at any time. Betty’s pain is constant, but slightly varies in intensity throughout the day without pattern. …show more content…
This current episode has been preceded by 3 previous attacks of bronchitis in the past 20 months. Each episode has lasted between 2 and 4 months and brings about intense fits of coughing with dyspnoea and wheezing. Betty insisted that it is normal for her to ‘have a round of heavy coughing’ every few months and attributes it to the season changing. Coughing fits occur at least once a day and require Betty to rest from whatever she is doing until the coughing fit ceases. This current episode of coughing is her worst to date. She smokes roughly 3-5 cigarettes a day and finds this makes her cough