James Walker

Patient reports recurrence of back pain, with onset linked to a workplace injury approximately three years prior. Symptoms recur with specific movements such as bending or twisting. Patient previously engaged in physical therapy with reported benefit but discontinued due to scheduling conflicts, relocation of the therapy office, and cost concerns. Patient also reports prior use of tramadol, which was effective but became cost-prohibitive.

None documented this visit.

Recurrent mechanical back pain, exacerbated by specific movements. Patient reports prior positive response to physical therapy and tramadol; both discontinued due to cost and access barriers. Cost of care and insurance limitations remain a significant concern.

Patient to utilize heating pad for short-term relief of back pain. Discussed alternative therapies including yoga, tai chi, and meditation, which may be more accessible and less expensive. Patient expressed interest. Discussed the possibility of generic medications and resources for finding affordable prescriptions in the future, but for the present, to stick with non-prescription options. Encouraged patient to review insurance options during open enrollment to find more cost-effective plans. Office staff to research discussed therapy options and pricing. Follow-up appointment scheduled for early next week (Tuesday) via phone to discuss research findings and potential next steps.