A 54-Year-Old Man Comes to the Office for an Initial

A 54-year-old man comes to the office for an initial appointment to evaluate lower back pain.  The patient's medical record shows that he has seen several physicians for back pain treatment.  He has been prescribed multiple pain medications and physical rehabilitation services but often stopped prematurely or did not follow through with recommendations.  At the beginning of the visit the patient says, "I'm tired of living with back pain, and I haven't been able to work in years.  Nothing has helped me-at this point I might as well just give up and go on disability."  Which of the following statements is the most appropriate initial response to this patient?

A) "Although previous medications have not worked, consultation with a pain specialist may be helpful."
B) "I understand the difficulty of your situation, but applying for disability will not improve your back pain."
C) "I understand your frustration, but it is difficult to help when you think nothing will work."
D) "It must be frustrating to have chronic back pain and feel like there are no options to ease your suffering."
E) "Your chances of improving would be better if you followed recommendations and remained in treatment."

Correct Answer:

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