chronic pain and fibromyalgia

Question 1

what is Fibromyalgia?

Answer 1

• Widespread pain with tenderness and stiffness independent of specific injury or lesion
• Unknown causes but thought to be abnormalities in the CNS
• Afferent pain signals appear to be amplified within the spinal cord with psychosocial and environmental factors adding to the amplification
• Psychosocial stress, certain infections, trauma can increase pain

Question 2

what is Chronic pain?

Answer 2

• Pain that is persistent or recurring for longer than 3 months; etiology may or may not be known
• When first detected, patients should be referred to the primary physician to determine causes and treatment

Question 3

what is Lower back pain?

Answer 3

• Pain located between the lower ribs and crease of the butt; etiology may or may not be known
• Risk factors = work, twisting, lifting, bending, repetitive motion, viberation, and static postures

Question 4

what is Central sensitization? 2 types?

Answer 4

• A phenomenon referred to as “wind-up” occurs when the CNS becomes high reactive to any touch, resulting in non-painful stimuli being painful
• Hyperalgesia = increased sensitivity to painful stimuli
• Allodynia = experience of painful sensation from stimuli that should not be painful. i.e., light touch

Question 5

Functional implications: ADL and IADLs

Answer 5

• ADLs
  o Less able to maintain independence than those without chronic pain
  o Pain, fatigue, and effects of resultant depression and anxiety can impact both motivation and performance
• IADLs
  o Impacted by pain caused by physical, cognitive, and emotional factors
  o IADLs are often limited with chronic pain

Question 6

how can you create an occupational profile for chronic pain?

Answer 6

• Chronic pain should be assessed to determine its impact on daily function using an occupational profile
• Good to understand ways in which chronic pain has disrupted their occupational roles and ADL supporting those roles, how the pain has impacted psychosocial health, daily mood, sleep patterns, daily stressors, and QOL

Question 7

4 assessments to create a pain profile

Answer 7

1. Pain diary = should be done for at least 2 weeks to get an understanding of pain occurrence, intensity and duration, triggers, activity level, patterns, mood and stress, time spent doing an activity, changes in pain levels with activity
2. Pain disability index = allows therapists to identify activities in which patients report experiencing heightened pain to address those areas and document change over time
3. Brief pain inventory = allows patients to document pain level in general life activities
4. COPM