What additional recommendations would you have at this time regarding pain management? Are there any other therapeutic issues that should be addressed? Reports of pin and needle pain sensations would indicate neuropathic pain.

The patient’s gabapentin dose has yet to be titrated from its initial starting dose. I would recommend an upwards titration of his gabapentin and/or adding another first-class neuropathic medication, such as a TCA or SNRI, to his regimen. According to the prompt, the patient is no longer taking an opioid. Although the patient requires several breaks during his therapy, we should avoid reinitiating opioids for chronic pain (Chisholm-Burns et al., 2019). I would suggest adding acetaminophen 1000 mg every six hours as needed for throbbing pains. Nonpharmacological interventions, such as massage or psychological rehabilitation, should also be considered. Erlenwein et al. (2021) report that “mirror therapy, proprioceptive training, virtual reality, and