Interventions I Review Flashcards
What is pain according to the Mature Organism Model (MOM)?
Pain is experienced because it helped our ancestors survive and avoid danger, evolving into pain-avoiding creatures.
What are the three dimensions of pain?
- Sensory dimension
- Cognitive dimension
- Affective dimension
What is the Neuromatrix theory of pain?
The Neuromatrix theory suggests that pain is produced by the brain, involving multiple areas in response to various inputs.
What is nociceptive pain?
Nociceptive pain is ‘normal pain’ with a short duration, well localized, and without electric qualities.
What is neuropathic pain?
Neuropathic pain is ‘electric pain’ traveling along a dermatome or peripheral nerve pattern.
What is central sensitization?
Central sensitization is chronic pain where pain has spread from original areas in a non-dermatomal pattern.
What is the biomedical approach to pain?
It involves medical/pharm treatments, anatomical education, and emphasizes pain not function.
What is the biopsychosocial approach to pain?
It focuses on PNE, therapeutic alliance, and addresses catastrophizing, rumination, fear-avoidance, and sensitization.
What is allodynia?
Allodynia is pain evoked by a normally benign stimulus such as cold, heat, or light touch.
What is hyperalgesia?
Hyperalgesia is an increased perception of pain elicited by a noxious stimulus.
What is the role of cortisol during stress?
Cortisol is a catabolic hormone that helps the body respond to stress.
What is the hypothalamus-pituitary-adrenal axis?
It is activated during periods of stress and homeostatic imbalance.
What is the locus of control?
It is a person’s belief regarding causality between their behavior and consequences.
What is the difference between internal and external locus of control?
- Internal: belief that outcomes are due to own actions.
- External: belief that outcomes are beyond one’s control.
What are the levels in the hierarchy of listening?
Ignore the message, pretend to listen, selective listening, attentive listening, empathetic listening.
What is the difference between positive and negative body language?
Positive body language includes sitting on edge of seat, standing with hands on hips, moving closer; negative body language includes downcast eyes, crossed arms, fidgeting.
What are the four communication zones?
Public zone, social zone, personal zone, intimate zone.
What are the four pillars of pain neuroscience education (PNE)?
Educate about pain, therapeutic alliance, aerobic exercise, sleep hygiene.
What do avoiders need in terms of pain education?
‘Hurt doesn’t equal harm,’ ‘sore but safe,’ no freaking out about flare-ups.
What do persisters need in terms of pain education?
They need pace, progression, and to break up activities to avoid a ‘boom or bust’ pattern.
What is the hourglass principle of sleep?
By the time you get to bed, your body should be out of energy, stimulating the release of melatonin, which tells the brain to relax.
How does sleep affect pain?
Sleep affects pain through dopaminergic and opioidergic signaling, influencing pain perception and affect.
How does caffeine affect pain relief?
Adding caffeine to analgesics for acute pain can improve pain relief by 5-10%.
What is the analgesic effect of nicotine?
Nicotine has an analgesic effect via nicotinic acetylcholine receptors and can also improve attention.
How does alcohol affect pain?
Acute alcohol use has a dopaminergic effect, providing temporary reward and pain relief.
What is THC and its effect on pain?
THC is the most active ingredient in cannabis, providing analgesic effects.
How do opioids decrease pain transmission?
Opioids activate descending nerve fibers to decrease ascending pathways for pain stimuli.
What are absolute contraindications for manual therapy interventions?
Thrombophlebitis, uncontrolled HTN, infections, anticoagulant therapy, unstable fractures, osteomyelitis, myositis ossificans, certain skin problems, cancer, burns, kidney dysfunction, pregnancy, steroid hormone replacements, unhealed fractures.
What is mechanotransduction?
Mechanotransduction is the process where cells sense and respond to mechanical loads, promoting structural change.
What are the three steps of mechanotransduction?
Mechano-coupling, cell-cell communication, effector response.
What is Wolff’s Law?
Bone grows or remodels in response to the forces or demands placed on it.
How do tendons respond to mechanical loading?
Tendons increase in stiffness with higher intensity loading, especially >70% 1RM/MVC.
What is the physical stress theory for muscles?
Muscles adapt to tension by adding sarcomeres in series for eccentric loading and in parallel for concentric loading.
What is the principle of progressive overload?
Progressive overload involves progressively increasing the load on tissues to induce positive adaptations and increase tissue compliance and stability.
What is the focus of sub-acute exercise interventions?
Maintain or increase cardiorespiratory fitness, restore full ROM, increase strength, reestablish neuromuscular control.
What is neuromuscular control?
Neuromuscular control is the ability to produce coordinated movement by integrating visual, proprioceptive, and kinematic information.
What is the safest repetition to begin with in early exercise prescription?
Slow concentric and slow eccentric with a full pause between reps to eliminate momentum and tension shunting.
How should exercise progression be aligned?
Progression should be aligned with the stage of healing and tissue integrity, focusing on strength, endurance, and coordination.
What is the difference between nociceptive and neuropathic pain?
Nociceptive pain is well localized and short in duration, while neuropathic pain is electric and follows nerve patterns.
How does central sensitization differ from other pain types?
Central sensitization involves widespread pain beyond the original injury and is often out of proportion.
What are the benefits of aerobic exercise for pain management?
Aerobic exercise at 50% VO2 max for 10 minutes can result in hypoalgesia.
What is the impact of deconditioning on pain?
Deconditioning can lead to increased pain perception and decreased functional capacity.
What role does dopamine play in pain and sleep regulation?
Dopamine is a key neurotransmitter in the forebrain reward system, regulating both sleep and pain.
How does goal setting influence pain management?
Setting specific and measurable goals can help guide the patient’s process and improve adherence to treatment.
What are healing words and their effect on pain?
Healing words can activate endogenous opioid centers, reducing pain perception.
What is the placebo effect in pain management?
The placebo effect, better thought of as ‘context effect,’ can trigger endogenous dopamine and improve pain relief.
What are the effects of caffeine on cortisol levels?
Caffeine can diminish but not abolish cortisol levels in regular users at moderate doses (300 mg/day).
What is the effect of alcohol on white matter integrity?
Higher alcohol consumption is associated with lower white matter integrity and reduced right hippocampal volume.
How does progressive underload affect tissues?
Progressive underload decreases tissue compliance and stability due to lack of stress.
What is the importance of feedback in early exercise prescription?
Feedback helps with motor learning and prevents bad habits, ensuring proper technique and safety.
What is the hourglass principle in sleep hygiene?
By bedtime, your body should be out of energy, stimulating melatonin release and relaxation.
What is the role of endogenous opioid peptides in pain?
Endogenous opioid peptides play a key role in descending pain inhibitory systems.
What are the effects of cannabis on pain management?
Cannabis, particularly THC, has analgesic effects and can help manage pain.
