Exam 1 Treatment of Central Sensitization Pain

Question 1

what three things are we using to treat

Answer 1

PNE
stress management
graded activity and exercise therapy

Question 2

what is the overall goal of PNE

Answer 2

teach about pain, reconceptulaize it, reduce the threat and less fear

Question 3

how does stress work

Answer 3

the hypothalamus sends signals to the pituitary gland which goes to the adrenal gland and then releases cortisol and EPI and NE

Question 4

when we are stressed, there is an increase in cortisol and NE, and what does this do to the brain

Answer 4

increases excitatory synapses in the hippocampus amygdala and prefrontal cortex

Question 5

central sensitization entails…

Answer 5

a change in the synaptic efficiency. More NT and synapses and receptors to transmit pain signals

Question 6

how does stress lead to central sensitization

Answer 6

GABA and serotonin decreases, so there is less inhibition, and you get higher levels of central sensitization

Question 7

what can decrease stress and pain

Answer 7

mindfulness, medications nd Schultz relaxation

Question 8

does walking and movement increase or decrease the firing of the pain matrix

Answer 8

decreases the firing

Question 9

what must exercise address with cognitive emotional sensitization

Answer 9

catastrophizing, kinesiophobia, stress, depression

Question 10

should we ever say
“I stop gardening when it hurts”
“or tell me when it hurts and we will stop”

Answer 10

no because you are saying there will be more pain, which will cause them more pain

Question 11

TF: we want to flare people up and tell them to work through the pain and we want to cause them pain

Answer 11

false

Question 12

are isometric exercises good

Answer 12

no, can flare up

Question 13

eccentrics?

Answer 13

can flare them up

Question 14

TF: we can do exercises with activity pacing to decrease flaring up and promote recovery

Answer 14

true

Question 15

what is a treatment program look like

Answer 15

PNE, stress, activity self management, graded exposure, recovery

Question 16

what is the fear center

Answer 16

amygdala

Question 17

normally, what happens with loops in the brain

Answer 17

the loops try to override to signal saying hey remember this, and the pain and the experience

Question 18

TF: we must train in painful positions with our athlete do we do not let their body remember the motion and equate it to pain

Answer 18

true think tennis player

Question 19

do we get angry with pain

Answer 19

yes, we think about previous injustice and anger

Question 20

movement may trigger fear in what region

Answer 20

amygdala

Question 21

TF: movement patterns change because we anticipate pain

Answer 21

true

Question 22

how can we initially start a training program

Answer 22

have the patient think about activity, or their pain, and watch someone else do it to ease back into it, graded exposure

Question 23

how can we retrain the memory of fear

Answer 23

ask them what we think will hurt it, and on a scale of 1-100. then ask them why? and explain to them, challenge their beliefs

Question 24

central sensitization take home messages

Answer 24

PNE first
then stress to reduce the central sensitization
then graded activity and exercise to dampen things
then exercise and retraining memories.