Exam 1 Flashcards
What is pain?
An unpleasant sensory & emotional experience associated with actual or potential tissue damage.
What impact does pain have on an individual?
- Limits participation in ADLs
- Limits function
- Limits ROM & strength
Managing pain enhances:
- Healing of soft tissue
- ROM & strength
- Functional tasks
- Participation in ADLs
What is the most common reason for seeking medical attention?
Pain
What can pain symptoms contribute to?
- Structural deficits
- Protective guarding
- Anxiety/decreased sleep
- Edema
- Joint stiffness
- Tissue shortening
- Poor positioning (posture)
- Compensatory movements
Pain symptoms are related to…
- Trauma
- Injured tissue
- Inflammation
- Muscular/neurological conditions
- Degenerative disease
- Pathological conditions
What is the function of pain?
It serves as a protective factor, protecting the body from injury.
PAMS control pain in what ways?
- Inhibiting inflammatory response
- Altering nerve conduction
- Increasing endorphin levels
- Inhibiting pain transmission at SC
Advantages of PAMs are?
- Fewer & less severe side effects than pharmacological agents
- Don’t cause sedation & allow continued work & driving
- PAMs can be used in conjunction w/ home exercises
OT goals related to pain?
- Diminish/resolve pain symptoms
- Understand pathology causing pain
- Modify pts perception of discomfort
- Maximize function within pts limitations
Which stage of pain are PAMs most effective for treating?
Acute
How long does Acute pain last for?
Typically less than 6 months.
If more, = chronic pain.
What are standard treatment Goals for Acute pain?
- Reduce inflammation
- Facilitate resolution of pain
- Modify transmission of pain from peripheral system to CNS
- Educate pt of pain management techniques
What are the pre reqs for Chronic pain?
- Persists beyond “normal” healing times.
- Starts as Acute pain
- Lasts longer than 3-6 months
When pain is experienced in a region another, separate location of tissue damage, what type of pain?
Referred pain
What type of fibers are in Nociceptors?
C fibers: small unmyelinated fibers. (80%)
Delta fibers: small, myelinated fibers (20%)
What type of pain is experienced through Nociceptor fibers?
C fibers: Slow, chronic pain.
Delta fibers: Fast, acute pain.
What is the Gate Control Theory?
Analgesic effect:
PAMs partially control pain by activating non-nociceptive sensory nerves.
- Inhibiting the activation of pain-transmitting cells closes the gate to pain.
What are the different types or pain and what do they typically feel like?
- Acute pain: Fast & sharp.
- Chronic pain: Slow, prolonged.
- Referred pain: Pain is experienced in another region separate from the origin. E.g., joint to joint, peripheral n. to distal innervation, organ to musculoskeletal tissue.
What is the role of Histamine?
Inflammatory response–Mediator of Itching.
What are the effects of heat modalities?
Increases:
* Blood flow (beneficial for Ischemia)
* Metabolism
* Oxygen consumption
*Capillary permeability
* Inflammation (acute injury within last 24-72 hrs)
* Muscle contraction velocity
* Nerve conduction velocity (beneficial for healing nerves)
* Pain threshold = Analgesic effect, decreasing nerve conduction velocity (Gate Theory)
* Elasticity, extensibility, flexibility of tissues
Decreases:
* Fluid viscosity (thickness)–increasing blood flow.
* Pain: Soothing, calming.
* Muscle spasms.
What are the effects of cold modalities?
Has an Analgesic effect–decreasing nerve conduction velocity.
- Increases viscosity (thickens)
- Causes Vasoconstriction (hypodynamic) = increasing BP
- Increases pain threshold
- Decreases inflammatory response
- Decrease edema
