L31 Self -management Flashcards
What is the biopsychosocial framework for management of patients with neck pain and headache?
What are 6 pathophysiological/biological features of biopsychosocial framework?
- Pain/sensory features
- Altered psychosocial features resulting
- Altered articular and movement features
- Nerve tissue: irritation, compression mechanosensitivity
- Altered neuromuscular control; muscle properties
- Altered postural control
What are 5 psychological features of biopsychosocial framework?
Idiopathic neck pain
- Anxiety
- Distress
- Depression
- Fear avoidance behaviours
- Poor coping skills
Important to consider….
- Difference between idiopathic and traumatic neck pain
- 85% of patients have no psychological problems
- Some are normal physiological reactions to having neck pain
What are 5 work factors of biopsychosocial framework?
- Impact of computer use on musculoskeletal symptoms and productivity emerging as important issue
- 12 month prevalence neck symptoms in office workers estimated at 50-76%
- 60-80% office workers report recurrence of neck pain one year after initial episode (Carroll et al 2008)
- Loss productivity –absenteeism, presenteeism
What are 7 social factors of biopsychosocial framework?
- Gender
- Emotional problems
- Poor job satisfaction
- Poor physical work environment (Eg. confined working space)
- Occupation type
- Smoking
- Awkward work postures
What is the changing biopsychosocial model?
What are 3 bio multimodal management approach for neck pain?
- Manual therapy
- Specific exercise
- Patient self‐management techniques
What are 2 psycho multimodal management approach for neck pain?
- Explanation of what influences symptoms
- Effects of stress
What are 2 social multimodal management approach for neck pain?
- Work – ergonomic advice
- Discuss how social/lifestyle choices impact
What is the management of neck pain when confirming cervicogenic diagnosis?
Confirm cervicogenic diagnosis
- History and
- 3 physical findings
What are 5 multimodal biopsychosocial approaches in the management of neck pain?
- Manual therapy (Csp and Tsp)
- Specific exercise cervical muscles
- Self‐ management techniques
- Education on agg practices
- Ergonomic
What are 4 characteristics of self-management?
- Theories and research
- Work is a positive health behaviour for which self management skills are essential (Johnston 2013)
- Role of clinician
- Problem solving
- Decision making
- Resource utilisation
- Therapeutic alliance
- Making an action plan
- Mange chronic pain and disability for recurrent MS conditions
What are 5 roles of the clinician in sel-management?
- Problem solving
- Decision making
- Resource utilisation
- Therapeutic alliance
- Making an action plan
How can you do self management?
- Partnership between therapist and patient
- Individual
- Groups
- Telephone counselling
- Web based self‐instruction
- May require a change in perspective from carer ‐ role
What are self-management skills and tips?
What are 8 benefits of self-management?
- Decreased pain
- Increased pain self‐efficacy
- Decreased general disability
- Improved psychological well‐being
- Reduced stress
- Depression
- Anxiety
- Catastrophisation
- Increased positive self‐talk
- Greater use of social support
- Increased time physical activity
- Increased general self‐efficacy
What are 11 steps for self-management?
- Establish rapport
- Active listening
- Provide information
- Develop an action plan
- Set realistic goals with patient (shared decision making)‐SMART
- Non‐judgemental approach
- Facilitate problem solving
- Promote self‐efficacy
- Link patients with resources
- Keep a health record
- Active follow up
What are the potential threats to effective self-management?
Acute WAD
Advice /education
What would your self‐management strategies
include?
Cervical radiculopathy
Advice /education
What would your self‐management strategies
include?
- Pain management:
- Positions of comfort and relief (antalgic posture –> keep position to not change posture)
- GP for
- Ergonomic advice (not to aggravate)
- Keep active
- Comfortable sleeping positions
- Exercise (a bit but not closing down the IF)
- Movements into easing position –> neutral range
Thoracic pain exacerbated by breathing
Advice /education
What would your self‐management strategies
include?
- ROM exercises
- Breathing exercises
- SNAG (towel around + MWM = support ribs)
- Flexion, ext, rot
- Advice
- Mechanical pain –> reduce fear
- Keep active
TMJ pain and restricted mouth opening
Advice /education
What would your self‐management strategies
include?
