System InteractionsDifficulty 3/5
A 68-year-old with a history of breast cancer reports two weeks of thoracic pain, worse at night, unrelieved by position change, with unintentional weight loss. What is the appropriate action?
- ABegin thoracic mobilisation and postural retraining, then reassess
- BRefer for medical evaluation before initiating physical therapy treatment
- CApply modalities for pain relief and review the response in one week
- DPrescribe a home exercise programme and follow up in two weeks
Show answer and rationale
Correct: B. Cancer history, night pain unrelieved by position and unexplained weight loss are red flags for metastatic disease. Referral precedes treatment, however mechanical the presentation appears.
- A — Mobilisation could be harmful in the presence of possible bony metastases.
- C — Symptomatic relief delays diagnosis of a potentially serious condition.
- D — A home programme also delays necessary medical evaluation.