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fall A 2024 > interventions midterm > Flashcards

interventions midterm Flashcards

1
Q

what is pne utilized for

A

healthier responses to pain

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2
Q

nociceptive pain

A

short duration
well localized

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3
Q

neuropathic pain

A

pain travels

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4
Q

neuroplastic plain

A

persistant, chronic
spread in non dermatomal pattern
intensity out of proportion

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5
Q

pain neuroscience education

A

change belief that pain is marker of injury or disease

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6
Q

is there a pain signal or center in the brain?

A

no
pain is an experience

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7
Q

what is pain?

A

appraisal made by our protection system based on neural representation of threat/danger

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8
Q

our knowledge of pain is limited

A

its still in infancy
its complex - opioid epidemic didn’t solve it.
still learning about chronic pain

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9
Q

MOM (mature organism model of pain)

A

we evolved to tolerate pain
helps us to survive and pass on genes
stress response
pain helps us avoid bad things

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10
Q

What would happen if we didnt feel pain?

A

may not survive to adulthood
harm themself
dont realize they are hurt

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11
Q

what is the brain’s role in MOM?

A

continual sampling of the outside environment, own body, and relevant past experiences
experiences coded into memories

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12
Q

through what process does the brain scrutinize during MOM?

A

somatic: muscles
autonomic: subconscious control of body
neuroendocrine
immune

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13
Q

3 dimensions of pain in MOM

A

sensory: anatomical descriptions
cognitive: thoughts
affective: emotional reaction

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14
Q

how does MOM guide treatment?

A

therapeutic interventions (change tissue inputs)
therapeutic interactions (change environmental input - sleep better, stimulate parasympatetic)
therapeutic reframing (change brain’s self-sampling input via therapeutic neuroscience education)

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15
Q

input not mandatory

A

some neural processes can act in the absence of any inputs

stress and depression can cause physical pain
phantom pain in amputees

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16
Q

role of neural networks

A

suggests origins of patterns which underlie experiences lie in brain neural networks

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17
Q

the self

A

body perceived in unity
pain breaks the unity

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18
Q

genetic compenent

A

may explain why some are more at risk for chronic pain or maladaptive pain

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19
Q

neuroignature/neurotag

A

synaptic arrangement of multiple centers in the brain
modulated by protection being highest priority
fired together are wired together
thoughts affect ability

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20
Q

failed homeostasis equals

A

conditions producing chronic pain

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21
Q

cortical smudging

A

poor localization
blurring of pain map
need to retrain where the body is

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22
Q

biomedical approaches

A

medical/pharm treatments
anatomic education
emphasis on pain not function
facilitating avoidance

all have poor - modest results

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23
Q

biopsychosocial approach

A

emphasize PNE
develop therapeutic alliance with pt
focus less on diagnosis and more on changing maladaptive behaviors

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24
Q

central sensitization

A

become efficient at feeling pain
increase perception of pain in other regions
changes in properties in neurons

CNS is now on higher alert

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25
allodynia
normally benign stimulus cold, heat, light touch
26
hyperalgesia
increased perception of noxious stimulus
27
secondary hyperalgesia
spread beyond initial injury site
28
catastrophizing
worse case thinking interpersonal coping style affects family and caregivers Let every photograph be taken from my bad side So when the world sees my face They'll never ask why I look the way I do
29
ruminating
overthinking and worrying about pain
30
pain related outcomes
increased behavioral pain expressions more illness higher pain severity alterations in social support networks partner either overprotective or over it
31
how can you treat catastrophizing?
graded exercise or exposure hurt doesn't equal harm
32
fear avoidance
avoid movement over guarding find what they can do do not say "avoid what hurts"
33
role of stress on pain
HPA axis (hypothalamus-pituitary adrenal axis) activated during periods of stress and homeostatic imbalance amygdala activates HPA during stress hypothalamus releases CRH pituitary gland secretes ACTH ACTH acts to release cortisol from adrenals
34
stress-pain likelyness
7-8x more likely to develop chronic pain
35
cortisol
helps respond to stress good for ST, but not for LT
36
what is the LT stress effect?
if cortisol fails to function, we run out of fuel lead to lack of other hormones
37
hypo-corisolism
parasym and sym out of wack never get to rest and digest
38
locus of control
generalized attitude or belief regarding causality benefits of internal: what can I control?
39
hierarchy of listening
ignore message pretend to listen selective listening attentive listening empathetic listening
40
three levels of maladaptive cognition
core beliefs dysfunctional assumptions negative automatic thoughts
40
progressive relaxation
paired with mindfulness techniques to being sensory levels down to manageable level
41
motivational interviewing
toward behavioral change, some aspects very good for establishing rapport and trust express empathy develop discrepancy roll with resistance support self efficacy
42
4 pillars of PNE
educate about pain aerobic exercise sleep hygiene goal setting
43
PNE
emphasizes that any credible evidence of danger to body tissues can increase pain and any credible evidence of safety can decrease pain
44
pain education
don't overload therapeutic alliance not hands off
45
avoiders
fearful of movement tasks "I can't" slowly but surely they don't do enough
46
persisters
do too much "I have to" need to stop the boom vs bust
47
graded exercises
for avoiders small amounts to build up hurt doesnt equal harm sore but safe
48
pacing exercises
for persisters slow them down don't let them go crazy goals: functional and fun
49
5 rules to move despite pain
focus on LT benefits not ST pain improve beliefs first only grade avoided improve stress tolerance improve sleep self-management
50
how sleep affects pain
happy hormones decline when you lack sleep dopamine regulates sleep
51
reccomendations for taking care of YOU when treating chronic pain pts
longer treatment times limiting the numbers of chronic patients in a day some wont buy what you are selling threats and stress can affect you as well provide a pathway not an absolute cure
52
factors predicting burnout
limited self-awareness inability to set professional and personal boundaries limited control over scheduling mounting time pressures negative attitudes toward psychosocial care
53
attitudes and beliefs what do you think is the cause of your pain? what info is gained?
fear/avoidance catastophization maladaptive beliefs passive attitude toward rehabilitation expectations of effect of activity or work on pain
54
behaviors what are you doing to relieve your pain? what info is gained?
use of extended rest reduced activity levels withdrawal from ADLs and social activities poor sleep boom-bust behavior self-medication - alcohol or other substances
55
compensation issues is your pain placing you in financial difficulties? what info is gained?
lack of incentive to return to work disputes over eligibility for benefits, delay in income assistance history of previous claims history of previous pain and time off work
56
diagnosis and treatment you have been seen and examined for your pain? are you worried that anything may have been missed? what info is gained?
health professional sanctioning disability conflicting diagnoses diagnostic language leading to catastrophizing and fear expectation of "fix" advice to withdrawal from activity and/or job dramatization of back pain by health professional producing dependency on passive treatments
57
emotions is there anything that is upsetting or worrying you about the pain at this moment? what info is gained?
fear depression irritability anxiety stress social anxiety feeling useless or not needed
58
family how does your family react to your pain? what info is gained?
over-protective partner/spouse solicitous behavior from spouse socially punitive responses from spouse support from family for return to work lack of support person to talk to
59
work how is your ability to work affected by your pain? what info is gained?
history of manual work job dissatisfaction belief work is harmful unsupportive or unhappy current work environment low educational background low socio-economic status heavy physical demands of work poor workplace management of pain issues lack of interest from employer
60
OARS
open questions affirmations reflective listening summarizing
61
positive body language signals
sitting on edge of seat standing, hands on hip tilted head moving closer rubbing palms together uncrossed arms body leaning forward hand on cheek touching chin relaxed mouth, chin forward
62
negative body language signals
rocking motion of torso downcast eyes/lack of eye contact arms crossed leg or foot swinging foot or finger tapping short breaths/sighing wringing hands slumping in chair/fidgeting in chair lowering of chin hunched shoulders fist clinched legs crossed body turned slightly away grooming yawning signs of being nervous
63
soft tissue manual therapy indications
tendonopathy, tendonosis myofascial pain syndromes trigger points ligament pain syndromes scar tissue adhesion entrapment syndromes
64
myofascial release
mild combo of pressure and stretch used to free ST restrictions particularly in the fascia john burns no oils or emollients slow holds larger areas cross handed techniques
65
myofascial release techniques
45 degree stroke: maintain pressure and wait for CT to unwind skin rolling: start with direction of ease and reverse to direction of restriction C-stroke: variation of skin rolling when difficult to lift and grasp tissues in a roll
66
pin and stretch, bend and stretch, ART
combo of precisely directed tension with very specific patient movements. pin down muscle in shortened position and elongate away from stretched position. muscular acute conditions, smaller areas hypoxia (scar tissue)
67
cross friction massage
for tendon junctions perpendicular or circular motion created small microtrauma to get collagen synthesis
68
ischemic compression/trigger point release
trigger point is hypertonicity several factors: mechanical stress, poor posture, insufficient hydration, inadequate sleep may take 30-45 seconds strumming is more aggressive
69
instrument assisted soft tissue mobilization
using instrument to assist saves your hands uses lubricant alcohol to remove lubricant from skin break up irregular abnormal densities in tissues
70
optimal treatment window
2-12 weeks post injury
71
effects of IASTM
increased fibroblastic activity davis law: lengthen or shorten based on the forces or lack of forces placed on them
72
IASTM strokes
sweep: broom fan: turns around axis brush: shorter sweeps strum: guitar swivel: back and forth scoops j-stroke: making j shape scoop: dig down and then lift up along edge framing: rectangular direction
73
what does generalized central sensitization sound like?
I have persistent pain and don't know why. no catas, rum, fear, stress, or locus issues can get better with education about PNE
74
foot stepping on nail card
when step on nail, alarm goes off. this is normal sometimes the alarm doesnt shut off or can be easily retriggered
75
before pain/after pain card
the continued pain is a nerve problem not tissue pain alarm goes off despite no tissue damage or threat
76
leaf card
house alarm sets off because of a leaf blowing by. there is no threat. this happens to 1 in 4 individuals
77
nosy neighbors card
other systems in body get altered when nervous system becomes overactive. this explains why you might have GI problems, sleep problems, ect
78
lion card
we have evolved to sense danger to stay alive the fear we have now is not the same fear we had but our body still reacts the same.
79
hurt does not equal harm card
sore can still be safe can you walk a minute? graded exercises
80
runner card
exercise produces natural chemicals like opioids without the side effects. can help to lower sensitivity of nervous system
81
car dashboard card
check engine light is on, but the car is actually ok keep calm and move on to help decrease pain
82
body card
we can tolerate stress when functioning correctly. injuries can be more complicated when stress is involved
83
boiling cup card
stressors act as an open flame heating your cup fears, anxiety and frustration only exacerbate sensitivity in nervous system
84
teeter totter card
sympathetic not designed to run for long periods of time would pain be better if you could relax more?
85
measuring cup and alarm card
increased emotion actives alarm how can you reduce your stress?
86
storm cloud card
increased stress chemicals create side effects could all this be tied to your pain?
87
tissue vs pain problem card
the more you know about pain, the lees you will experience
88
car pile up card
only 2-3% of demo drivers experience long lasting pain
89
spine card
40% of bulging discs produce no pain discs fluctuate quite a bit during the day
90
graph card
develop a little arthritis in 20's arthritis and back pain are not causal

fall A 2024 (10 decks)

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