Chronic pain syndrome

The patient is here for followup appointment for her bilateral knee pain and refill of pain medications. The patient has history of multiple, at least seven surgeries in the left knee and osteoarthritis of the right knee. She is stable on the current regimen of pain medications. Pain level is 5-6/10. last few days her pain was much better controlled, but yesterday she came back and the pain has also started coming back again. She denies any memory impairment. No sedation, nausea, itching, or high with medications. She is more active and functional on medications. She uses cane when she goes outside. Inside the house, she is able to walk without the cane. She denies any other changes in her past medical, surgical history, social history, or review of systems.

DIAGNOSES:
Chronic pain syndrome.
Right knee osteoarthritis.
Status post multiple surgeries left knee.

RECOMMENDATIONS:
We will continue with Duragesic patch 25 mcg one every 48 hours, #15 dispensed and Norco 7.5/325 mg one tablet every six hours as needed for pain, #120 dispensed. We will see the patient back in followup in one month.

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