Pain Flashcards
What aspects does OT address with pain
biophysical
psychological
social
Chracteristics of acute pain
last sec-days
no longer than 6mo
sudden onset
What is the function of acute pain
Warning or protection
What accompanies acute pain
inflammation and more localized
What is chronic pain
Recurs at intervals more generalized 6mo + Anguish, depression Dull aching
What is referred pain
Pain perceived to be in areas other than where the nociceptors are stimulated
tigger points are often present
What is nocioceptive pain
Specific to a stimulus
hot
sharp
issue irritation
What is the type of pain response dependent on
excitatory inputs
C fibers
A delta fibers
characteristics of C fibers
Slower
onset after stimulus
pain is dull, throbbing, aching, burning
ma be accompanied by increased HR, sweating, difficult to withstand for long periods
Characteristics of A delta fibers
move quickly
onset at time of stimulus
sharp, stabbing, prickling
What is the order of activation of nociceptors
Nociceptors to PNS to Spinal cord to Brain then back to body part
What is visceral pain
subtype of nociceptive pain
Characteristics of Nociceptive pain
sudden onset
poorly localized
viscus
What is viscus
organ of the digestive, respiratory, urogenital, endocrine system
Characteristics of somatic pain
constant
localized
Somatic
What is somatic
relating to the body in general; skeletal muscle
What causes neuropathic pain
illness or injury to the PNS or CNS
What does neuropathic pain feel like
Burning
lancinating, sharp, knife like
Electric, shock like
What can trigger neuropathic pain
non painful stimulus (light touch, cool breeze)
Examples of neuropathic pain
Fibromyalgia
complex regional pain syndrome
How to treat neuropathic pain
proactively and quickly b/c it can be indicitive of a more serious issue
What is the concept of the neuromatrix theory
pain is produced by the output of a neural network in the brain
Characterisitcs of the neruromatrix theory
genetically determined
modified by sensory experience
mechanism that generates the neural pattern produces pain
somatic seonsry input= only 1 factor contributing to pain
Concept of the gate control theory
modulation of peripheral stimuli occurs in the dorsal horn of the spinal cord
What do large a beta fibers do
close the gate (don’t allow message to go through)
inhibitory input
Wat do small c fibers do
open the gate (allows message to go through)
What is the basis of the theory for TENS
Gate control
What is severity of pain determined by in the gate control theory
balance of excitatory and inhibitory inputs
Treatment in the gate control theory
used to treat acute pain
tx applied at site of pain
efffects of tx last for duration of tx and shortly after
pleasant sensation
What is the concept of the opiate-mediated pain theory
endogenous opioids affect both the CNS and PNS through the interaction of specific chemo-receptors and pain mediating substances
What is the endorphin theory utilized for
chronic pain
Characteristics of the endorphin theory
Tx applied at and around site
effects last beyond tx
often unpleasant noxious stimuli or less bearable persisting pain
main idea of the endorphin theory
decrease bad chemicals and increase good endorphins
What is the biophysical approach
multifaceted reaction based on anatomical, physiological, chemical, and psycholgical pactors
What does the biophysical approach take into account
behavioral, cognitive-affective, and environmental factors
What is a holistic tx approach to pain
Biophysical approach
What kind of pain responds well to pams
Acute pain
Why do pams not work well for chronic pain
bc there is no actual tissue damage
Treatment for chronic pain
Limited use of PAMS Behavior mod pt. edu Med general conditioning TENS
What do referred pain trigger points not respond to
Pams
How to stimulate trigger points
Acute overload overwork fatigue cold direct trauma to the muscles illness (flu) stress
what are trigger points
small localized hyersensative areas located in the muscle or fascia
Diagnostic criteria for tigger points
tenderness in a hyperirratible spot w/in a palpable taut band
a local twitch response
elicited referrred pain w/ palpitation
What are the 2 most common sources of pain seen clinically
peripheral neurogenic
peripheral nociceptive
where is peripheral neurogenic pain
neural tissue
Signs of perpheral neurogenic
limitations in motion
pain
parathesias
sensory changes
where is peripheral nociceptive pain
Often mechanical
Symptom of peripheral nociceptive pain
Inflammation
What to peripheral neurogenic and nociceptive respond well to
intervention
What to do in an initial eval for pain
find the underlying pathology
e.g. sprain, tear, fracture, infection, obstruction, arthritis, autoimmune disorder
Autonomic or sympathetic symptoms
Nausea
Sweating
flushing
sensation of hot or cold in affected area
What to look at in a pain assessment
Description of pain dev of it and history location pattern of it over time what exacerbates or diminishes it functional lvl or impairment previous interventions
Physiological responses to pain
Muscle spasms Guarding Fatigue Fear Weakness
