mechanisms and sources of pain

Question 1

What is the difference between local and referred pain?

Answer 1

• Local pain: felt in the area of nociception.
• Referred pain: nociception occurs elsewhere, pain is felt in a different location.

Question 2

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Answer 2

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Question 3

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Answer 3

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Question 4

What is embryologic referred pain?

Answer 4

Pain referred to the location of an organ from fetal development.

Question 5

What is multi-segmental innervation?

Answer 5

Viscera have multi-segmental autonomic contributions, causing pain to be referred to corresponding somatic areas.

Question 6

What is direct pressure referred pain?

Answer 6

• direct pressure on the central diaphragm refers pain to the shoulder
• pressure on the peripheral diaphragm refers pain to costal or lumbar areas

Question 7

What is neuropathic pain?

Answer 7

Pain that does not respond to opioids, often described as burning or electric.

Question 8

When should you refer a patient?

Answer 8

Referral is required when

• there is no movement dysfunction
• no causative factors,
• no identifiable syndrome

Question 9

What is somatic pain?

Answer 9

Pain from superficial or deep structures,

• Superficial: skin, superficial fascia, tendon sheath, periosteum
• Deep: bone, muscle, tendon, ligament, joint (including capsule), or deep fascia

Question 10

What is cutaneous pain?

Answer 10

• Cutaneous pain is a type of pain that originates in the skin or superficial tissues, and is often caused by injuries like paper cuts, minor burns, or lacerations.
• It’s characterized by a well-defined, localized pain that’s short-lived, due to the high concentration of nerve endings in the skin

Question 11

What is visceral pain?

Answer 11

Pain associated with the autonomic nervous system response, often from internal organs.

Question 12

What are the characteristics of psychogenic pain?

Answer 12

Psychogenic pain: Disproportionate to injury, persistent and not linked to identifiable physical causes.

Question 13

What are trigger points?

Answer 13

Areas of hyperirritability in muscle or fascia, leading to referred pain when pressed.

Question 14

What is tension pain?

Answer 14

Pain caused by muscle tightness or contraction.

Question 15

What are Waddell’s signs?

Answer 15

Signs used to identify non-organic or psychogenic aspects of chronic low back pain.