M4 Class Notes 2 Flashcards
Which of the following statements is the most appropriate statement to include in chronic pain pt education?
a. Our goal is to help you increase your activity and get you back to doing more of the activities you want to do, even if your pain persists
b. You became disabled because you gave into the pain and stopped doing your exercises
c. Acute pain starts quickly but tends to go away quickly, while chronic pain is very hard to get rid of
d. If you find that you’re sore from these exercises, then stop until I see you next time and I’ll change them
a. Our goal is to help you increase your activity and get you back to doing more of the activities you want to do, even if your pain persists
Which of the following best reflects principles of PT mgmt in chronic pain?
a. Assessment for black flags can help identify possible need for a chronic pain management type approach
b. To see meaningful improvement with such slow progress, pts benefit from a longer treatment duration between assessments
c. You taught better body mechanics with vacuuming last rx and instructed her to try it for 3 min that night and report back to you next visit
d. Asking a pt what his goals are for therapy is not appropriate because you want to avoid a focus on pain reduction
c. You taught better body mechanics with vacuuming last rx and instructed her to try it for 3 min that night and report back to you next visit
Which of the following best reflects principles of PT mgmt in chronic pain?
a. Assessment for black flags can help identify possible need for a chronic pain management type approach
b. To see meaningful improvement with such slow progress, pts benefit from a longer treatment duration between assessments
c. You taught better body mechanics with vacuuming last rx and instructed her to try it for 3 min that night and report back to you next visit
d. Asking a pt what his goals are for therapy is not appropriate because you want to avoid a focus on pain reduction
Why is C the best answer?
They need to focus on a gradual increase in activity, even if it’s a short period
Which of the following is the most appropriate statement related to specific treatment options for chronic pain?
a. With graded exposure, starting with an activity that is moderately threatening will demonstrate better pain reduction if it’s successful than starting with one that is less threatening
b. An exercise quota as part of a home program is different than a goal because it implies a requirement for a certain amount of exercise versus a target that is desired but not required
c. Cardio exercise is likely to benefit chronic pain pts in a number of ways and in order to increase compliance it’s good to let pts select their own activities as long as they’re dosed appropriately
d. Neuroscience education is primarily helping pts understand the multifactorial nature of central sensitization and pain and really isn’t intended to reduce pain
b. An exercise quota as part of a home program is different than a goal because it implies a requirement for a certain amount of exercise versus a target that is desired but not required
quota vs. goal
QUOTA: between now and next session, you need to do at least 5 reps/day
instead of
GOAL: do as many reps as you can, trying to get to 15 reps/day
quotas vs. goals for chronic pain pts
quotas often used more for chronic pain pts
Cardio exercise is likely to benefit chronic pain pts in a number of ways and in order to increase compliance it’s good to let pts select their own activities as long as they’re dosed appropriately
What is a potential problem with this?
Though it’s important to give them some control in their tx, they may have resultant abn tissue stresses because of what they choose
Neuroscience education is primarily helping pts understand the multifactorial nature of central sensitization and pain and really isn’t intended to reduce pain
What is wrong with this statement?
neuroscience education actually does decrease pain
Tylenol is just as effective as NSAIDs and has no side effects so it should be used as a first line tx for back pain
a. True
b. False
b. False
Tylenol DOES have side effects, just not as many as some of the others
chronic pain summary: Tylenol
- safe
- low cost
- first line pharmacological tx
chronic pain summary: NSAIDs
- no more effective than tylenol
- significant side effects, esp with increased duration
chronic pain summary: Cox2
- may have fewer side effects
- no more effective
chronic pain summary: Gabapentin
short term effects in radiculopathy
chronic pain summary: Benzos/mm relaxers
- short term relief
- risk for abuse/addiction
chronic pain summary: corticosteroids
not recommended, even in sciatica
