Orthopaedics Flashcards
What is Nociceptive pain?
Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors.
What is neuropathic pain?
Pain caused by a lesion or disease of the somatosensory nervous system.
What is Nociplastic / Nocipathic pain?
Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain
Why is proprioception important in treating chronic pain?
Patients with chronic pain need help with the proprioception
So treatment often involves electro with muscles contracting to improve function
Or distal needling with local movement
How does invasion of cold influence pain?
Cold Qi enters the channel and causes contraction leading to pain
When the cold attacks outside the vessel: there is decrease in blood flow (deficiency)
When cold attacks inside the vessel, Qi cannot flow
How many treatments do people with prolonged chronic pain need?
Most painful conditions need somewhere between 6 to 20 treatments to achieve a sustained pain reduction lasting a year.
6 treatments over 6 weeks is just not enough to gain benefits and two or more treatments per week over 6 weeks is better guide as a reliable dosage.
What is degeneration?
reduced blood supply, calcification, increase in fibrous connective tissue & decrease in functional tissue. From TCM perspective the area would be empty and therefore prone to disorder.
What is inflammation?
redness, heat, swelling and pain.
What is numbness?
Bilateral numbness of the hands and feet, or arms and legs, usually indicates Blood deficiency or a systemic neurodegenerative condition
What is tissue injury?
Leads to qi and blood stagnation. An area of the body can be more susceptible to tissue injury due to deficiency or excess, however excessive use or force on/of the area or incorrect movement can be greater than the body’s ability to neutralise, therefore resulting in injury.
Where can trigger points be found?
Trigger Points can also be found in tendons, ligaments, fascia, joint capsule and even the periosteum.
Why would trigger points be used?
Trigger points are a logical choice to ease pain, however they may not be the best choice for long term healing
Where is the motor point found?
Motor points are found in the central aspect of the muscle where the motor nerve enters the muscle, has the greatest influence on electrical activity and, as a result, the greatest impact on pain
How are motor points used clinically?
Address the injury by using local point in the affected agonist muscle and its antagonist muscle
Use the motor points of the innervating spinal segment corresponding Huato Jia Ji point in combination with the agonist and antagonist motor points to treat the injury.
What proximal point can be used to treat the ankle and why?
GB34 for an ankle condition>remember the muscles that move the ankle are on the lower leg. GB34 will target the nerves that dorsiflex and evert the ankle
Or could also include the needling of the HJJ of L4/L5 & L5/S1for the same ankle problem as this is where the nerve starts that will go to the lateral ankle.
