Pain Flashcards
Stimulation of peripheral pain nerve endings which transmit a signal to the CNS
Nocioception
Sensory & emotional experience associated with actual or potential tissue damage
Pain
Acute pain signals two things
- Real or impending tissue damage
2. Biological damage
Appears concurrent with either tissue damage or stress
Acute pain
Pain that persists after healing is complete
Chronic/persistent pain
What is the arbitrary time of chronic pain?
3 mo
OLDCARTS
Onset Location Duration Characteristics (type of pain) Aggravating factors Relieving factors Temporal Severity (VAS)
Goals should be _____________ oriented, not dependent on the _______________________
Functionally; cessation of pain
5 components of pain assessment interview
- Past treatments
- Describe original pain
- Stress factors
- Perception of cause of continued pain
- Ask how pt will know when he/she will be better
4 body diagrams for pain assessment
- Specific anatomical location of pain
- Referred pain
- Trigger points
- Myofascial pain
5 parts of physical exam
- Movement patterns
- Neuro exam
- AROM
- MMT
- Posture
What does active movement exam test?
Contractile movement
What does active movement exam provide info about?(3)
- Pts ability to move
- Painful range
- Location of originating pain
What does a passive movement exam test?
Inert structures - capsule, lig, bursa, fascia
What does passive movement exam provide info on?
Gross assessment of the length of extra-articular + periarticular soft tissue
If A + P motion are restricted in same direction…
Problem with capsule or bone
If A + P motion are restricted in opposite directions……
Contractile lesion (muscle strain, pull)
Define resistive motion
Isolation of contractile tissue by isometric contraction in midrange of joint motion
2 exceptions to resistive motion
- Fracture close to muscle insertion causing shifting of fractured ends
- Inflamed structure underlying muscle
Strength/pain pattern
Painless + strong
WNL or referred pain from another area
Strength/pain pattern
Painful + strong
Minor lesion of muscle or tendon
Strength/pain pattern
Painless + weak
Disorder of nervous system
Total rupture of myotendinous unit
Disuse atrophy
Strength/pain pattern
Painful + weak
Major lesion (fracture)
Acute inflammation
Partial rupture of myotendinous unit
Strength/pain pattern
Painful arc
Tender structure pinched between two bony surfaces
Strength/pain pattern
Pain with repetition of movements
Intermittent claudication
Putting a joint in its resting position results in _________________
Least amount of pain
Resting position is usually where joint capsule is ____________
Most lax
Resting position of hip
30 degrees flexion
Resting position of knee
30-45 degrees flexion
Resting position of ankle
15 degrees plantarflexion