MCTF Flashcards
What is the leading cause of disability worldwide
LBP
What is MCTF?
framework to create a diagnosis based on biopsychosocial model
What is nociceptive pain?
pain arising from actual or possible damage to tissue
What is the management for nociceptive pain?
staying active
analgesics
What is nociceptive inflammatory pain?
inflammatory pain is associated with acute tissue damage
what is the management for nociceptive inflammatory pain?
increase activity without pain flare
analgesics - disinflammatory
What is neuropathic pain?
pain caused by session to the peripheral somatosensory system
What is the management for neuropathic pain?
manual technique aggravates it.
meds- opioid, anti depressant, topical treatment
What is nociplastic pain?
pain arising from altered nociception with no evidence of tissue damage
-fibromyalgia
What is the management for nociplastic pain?
lifestyle change
patient education
interdisciplinary management
- anti-neuropathics
What is Mixed pain
a combination of various types of pain
What is the management for mixed pain?
education sensory motor training lifestyle encourage activity Meds.
What is mechanical pain?
Stimulus responds to activity.
Response proportional to stimuli
pain fluctuates with aggravating/ relieving factors
What is non Mechanical Pain?
Stimuli Independent from activity
exaggerated response to stimuli
constant pain - difficulty finding rest
What is sensitisation?
responsiveness to stimuli like posture, movement, palpation.
Low= low response to stimuli
High= alodynia
hyperalgesia
What are the cognitive factors?
catastrophizing
beliefs and expectations about pain
Affective factors?
Depression, anxiety, anger, fear, frustration and stress.
emotional response to pain
Social factors?
relationship, work, education. culture, health literacy
barriers to recovery
What is the leading cause of global disability?
- Chronicpain
- Cardiovasculardisease
- Lowbackpain
- Mentalillness
- Lowbackpain
When using the MCTF, pain that is arising from altered nociception despite no clear tissue damage or evidence of disease or lesion of the somatosensory system would be categorized as
- Nociceptive
- Neuropathic
- Nociplastic
- Mixed
- Nociplastic
Why would be want to ask a patient the questions like “how do these problems affect your daily activities” or “what are you able to do every day/”
- To acknowledge and address the individual’ sperspective of their pain
- To begin to determine the patient’s functional capacity
- To address a patient’s goals and expectations
- All of the above
- All of the above
What is the best management option for an injury classified in a ‘recurrent’ stage
- Immediate pain control and prevention of further tissue damage
- Gradual restoration off unctional capacity
- Investigation for potential contributing factors for long terms solutions
- Reinforce active management and on-refer if further advice is needed
- Investigation for potential contributing factors for long terms solutions
What are the management goals for someone who is presenting with non- mechanical type pain?
- Management would be focused on addressing relevant functional behaviors that are influenced by physical and psychological factors
- Management would first be to establish a functional baseline and then gradually expose them to increase physical loading
- Management would be focused on predisposing and contributing lifestyle factors
- Management would be focused one a sing the patient through difficult positions frequently but in short bursts
- Management would be focused on predisposing and contributing lifestyle factors
How to manage mechanical pain?
- Management would be focused on addressing relevant functional behaviors that are influenced by physical and psychological factors
How to manage low sensitisation?
somatic pain clinical guidelines
How to manage high sensitisation?
adress contributingfactos to the increased sensasitation such as neuropathic pain phsychosocial and lifestyle.
What tests are done for cognitive screening?
FABQ and TSK
What test are done for affective screening?
Dass
What test are done for social screening?
social questions
demographic
treatment for high results on cognitive screening?
targeted patient education
pain management and functional restoration
treatment for high results on affective screening?
psychological
pharmacological
physical activity
lifestyle intervention
treatment for high results on social screening?
consider liaison with workplace, family and social services
What is understood by whole person consideration?
general health, comorbidities, family Hx, Medications, genetics, general health concerns
what is the management for whole person consideration
- comorbities marked as delayed recovery
- refer for medical management.
What are helpful functional behaviours ?
behaviours that help to prevent further tissue damage / allow tissue healing
What are unhelpful functional behaviours ?
behaviours that are provocative of a disorder. may be persistent behaviours in the absence of tissue injury.
E.g. bracing
What are pain behaviours?
response to pain experience.
What is the management for functional behaviours
manage the underlying behaviour
patient education
pain management
A patient presents to you with loss of cervical spine movement due to a recent whiplash injury. Moving their neck around increases their pain, so they are wearing a supportive neck collar to prevent moving their neck at all. This is an example of
- Helpful protective behaviors
- Unhelpful protective behaviors
- Fear avoidance behaviors
- Pain catastrophizing behaviors
- Helpful protective behaviors