Lec 9 Flashcards
What do chronic pain scales measure?
Persistence
Intensity
Interference
Is generalized pain central or local?
CENTRAL
Each body site that has pain increases the chances of getting this.
Another pain disorder
Measures limitations in chewing tough food, hard bread, opening wide, swallowing, yawning, frowning, kissing, smiling, etc.
Jaw Functional Limitation Scale
Subscales of the Patient Health Questionnaire 4 (PHQ-4)
Anxiety and Depression
This test measures 7 items assessing ANXIOUS MOOD and BEHAVIOR:
1) Feeling nervous, anxious, or on-edge
2) Not being able to stop or control worrying
3) Worrying too much about different things.
4) Trouble relaxing
5) Being so restless that it’s hard to sit still.
6) Becoming easily annoyed
7) Feeling afraid like something awful might happen.
GAD-7
Asks questions about depression and anxiety:
1) Feeling nervous, anxious, or on edge.
2) Not being able to stop or control worrying.
3) Little interest or pleasure in doing things.
4) Feeling down, depressed, or hopeless.
PHQ-4
Assesses depression, including suicide.
PHQ-9
Assesses non-specific physical symptoms.
PHQ-15
This therapy uses the following:
- Biofeedback
- Relaxation
- Behavioral modification
- Cognitive behavior therapy
- Mindfulness
- Education
Biobehavioral Therapy
Overall goals of biobehavioral therapy.
- Self management
- Self control over pain symptoms
- Self control over impact of pain (disability level)
- Maintaining psychosocial function even if pain continues.
CBT stands for:
Cognitive Behavior Therapy
The use of exercises and physical activities to help condition muscles and restore strength and movement.
Physical Therapy
- Helps relieve musckuloskeletal pain.
- Helps restore normal function.
- Helps to coordinate and strengthen muscle activity.
Physical Therapy
Recognized as an effective conservative method of treatment for TMD.
Physical Therapy
TMD has nothing to do with this.
- Position of the head or body.
- Occlusion
Exercises that increase muscle strength.
Isometric
Increase range of motion.
Isotonic
In these exercises, you’re moving against resistance to increase muscle strength.
Isometric
Using an open palm against the chin or desired side.
Resistance
These devices increase range of motion.
Passive jaw motion devices.
Physical Therapy and Home Care for TMD:
- Transcutaneous electrical nerve stimulation.
- Acupuncture
- Ultrasound
- Iontophoresis
- Thermal therapy
- Manipulation (active or passive motion).
- Trigger point injections
This can be used as as adjuvant modality in the management of pain associated with TMD’s.
Transcutaneous Electrical Nerve Stimulation (TENS)
Don’t have enough evidence to say that this alone is effective in treating TMD pain.
Acupuncture.
This is thought to reduce pain by releasing endogenous opioids.
Acupuncture
This is more effective than placebo in reducing pain intensity in TMD, but we don’t yet know if it can be used as symptomatic treatment for TMD.
Acupuncture
What is Ultrasound used to treat?
Chronic TMD pain
This is NEVER a treatment method for TMD.
Occlusal adjustment
T/F: There's some evidence that the following can be effective in alleviating TMD pain: Occlusal appliances Acupuncture Behavioral therapy Jaw exercises Postural training Pharmacy
True
This is a significant factor in developing a high level of rapport and treatment compliance.
Time spend on patient reassurance and education.
The success of a self-management program depends on this.
Patient motivation
Cooperation
Compliance
A self-management routine should include the following:
- Rest of the masticatory system thru voluntary limitation of mandibular function.
- Habit awareness and modification.
- Home physiotherapy program
This should not be used for:
- Acute injury
- Acute inflammation
- Infection
Heat
These are used for local analgesic and anti-inflammatory effects in muscle and joint tissues.
Ice packs
Avoid drinking this for TMD issues.
Caffeine
