Holistic Nursing Approaches for Managing Chronic Back Pain and Acute Left Ankle Pain: A Comprehensive Discussion

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Chronic Back Pain Interventions:

Heat Therapy:

Rationale: Applying heat to the affected area can help alleviate chronic back pain by improving blood flow, relaxing muscles, and reducing stiffness. Heat therapy is known to soothe discomfort in chronic conditions by promoting vasodilation, which enhances oxygen and nutrient delivery to the muscles. Additionally, it can enhance the flexibility of soft tissues, providing relief from persistent back pain (Gouvaia, et al. 2017).

Exercise and Stretching Regimen:

Rationale: Regular, gentle exercises and stretching can significantly contribute to managing chronic back pain. Strengthening the core muscles and improving flexibility can provide better support to the spine and reduce strain on the back. Engaging in low-impact activities, such as swimming or walking, helps maintain an optimal weight, further reducing stress on the back and promoting overall musculoskeletal health (Gouvaia, et al. 2017).

Cognitive-Behavioral Therapy (CBT):

Rationale: Incorporating cognitive-behavioral therapy can be beneficial in addressing the psychological aspects of chronic pain. CBT helps individuals manage and cope with pain by identifying and modifying negative thought patterns and behaviors. It equips the patient with effective pain management strategies, promoting a positive mindset and enhancing the overall quality of life despite chronic pain (Gouvaia, et al. 2017).

Acute Left Ankle Pain Interventions:

R.I.C.E Protocol (Rest, Ice, Compression, Elevation):

Rationale: The R.I.C.E protocol is a standard approach for managing acute injuries, such as swelling in the left ankle. Rest minimizes stress on the injured area, ice reduces swelling and numbs pain, compression helps control swelling, and elevation facilitates drainage of excess fluid. This combination effectively manages acute pain and promotes the healing process (Gaddi et al. 2022).

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

Rationale: NSAIDs, such as ibuprofen, can be beneficial in reducing both pain and inflammation associated with acute injuries. By inhibiting prostaglandin synthesis, NSAIDs alleviate pain and discomfort. However, it’s important to consider contraindications and potential side effects, especially in older adults like Ms. Hernandez, and to administer them under the guidance of a healthcare provider (Gaddi et al. 2022).

Ankle Bracing or Supportive Devices:

Rationale: Providing external support to the injured ankle through bracing or strapping helps stabilize the joint, reducing strain and preventing further injury. This can significantly alleviate acute pain by limiting movement and promoting the healing of the affected tissues (Gaddi et al. 2022).


Gouveia, N., Rodrigues, A., Ramiro, S., Eusébio, M., Machado, P. M., Canhão, H., & Branco, J. C. (2017). The Use of Analgesic and Other Pain-Relief Drugs to Manage Chronic Low Back Pain: Results from a National Survey. Pain practice : the official journal of World Institute of Pain, 17(3), 353–365. https://doi.org/10.1111/papr.12455

Gaddi, D., Mosca, A., Piatti, M., Munegato, D., Catalano, M., Di Lorenzo, G., Turati, M., Zanchi, N., Piscitelli, D., Chui, K., Zatti, G., & Bigoni, M. (2022). Acute Ankle Sprain Management: An Umbrella Review of Systematic Reviews. Frontiers in medicine, 9, 868474. https://doi.org/10.3389/fmed.2022.868474


Nursing interventions for Chronic Back Pain and their Rationales

Cold application

Rationale: Cold application diminishes pain, inflammation, and muscle spasticity through vasoconstriction, limiting the release of pain-inducing chemicals and regulating the conduction of pain impulses. This intervention is cost-effective and requires no special equipment. Cold applications should be applied intermittently for no more than 15 minutes to avoid tissue injury. Cold can be especially effective in reducing the amount of pain that occurs during procedures.

Progressive relaxation exercises

Rationale: Progressive relaxation exercises involve the combination of controlled breathing exercises and a series of contractions and relaxation of muscle groups. After achieving complete relaxation, pain perception is lowered, and anxiety toward pain experience lessens. The client may stop the exercise, particularly when agitated or uncomfortable. With practice, the client learns to perform relaxation exercises independently.


Distraction is drawing the client’s attention away from the pain and focusing on something other than the pain. It is based on the belief that the brain can process only so much information simultaneously. Distraction can be visual, tactile, intellectual, or auditory. Visual distraction includes watching TV. Tactile distraction may include massage, hugging a favorite toy, or stroking a pet. Academic distractions include engrossing in a crossword puzzle or challenging game. Auditory distraction involves music therapy, which can also reduce anxiety.

Nursing interventions for Acute left Ankle Pain and their Rationales

Her physician ordered an x-ray, which was negative for fracture. We would treat it with rest, ice, and over-the-counter pain medication.

-Rest- would allow you to stay off your feet for a while

– Ice- would help reduce swelling

– Compression- would help with reducing inflammation when wrapped appropriately.

– Elevation- is good, and resting your ankle above your heart to reduce swelling.

– Over-the-counter pain medication- to help relieve pain and reduce swelling.


Faucett, J. (1999). Chronic low back pain: early interventions. Annual review of nursing research, 17(1), 155-182.

QIU, S. (2021). Current nursing interventions for adults with repetitive ankle sprains.

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