Pain Education Flashcards
What is the normal pain cycle
- Pain
- Pain experience
- No fear
- Confrontation
- Recovery
What is the pain fear/avoidance cycle
- Pain
- Pain experience
- Fear of pain
- Avoidance of activity
- Disuse/disability/depression
- Pain experience
Behavior yellow flags
- extend bed rest
- withdrawal from social life & daily life
- compliance issues with therapy
- report extremely high intensity of pain
- excessive reliance on use of aids or appliances
- problems sleeping
- high intake of alcohol & medication
- smoking
Compensation issues yellow flags
- lack of financial incentive to return to work
- history of claims due to other injuries or problems
Diagnosis and treatment yellow flags
- health professional sanctioning disability
- conflicting diagnoses
- diagnostic language leading to fear
- number of healthcare providers visited
- expectation of a “techno fix”
- lack of satisfaction with treatment
Work yellow flags
- history of manual work
- job dissatisfaction
- problems with peers & supervisors
- low educational background
- low socioeconomic status
- high physical demand
- working shifts
- negative experience of workplace management of pain or injury
Emotions yellow flags
- fear of increased pain with activity, work, or therapy
- depression
- irritability
- anxiety
Family yellow flags
- overprotective spouse
- punitive responses from spouse
What outcome measures would help identify patients who might benefit from pain education
- Fear avoidance beliefs questionnaire (FABQ)
- Pain catastrophizing scale (PCS)
- Tampa scale of kinesiophobia (TSK)
- Pain coping inventory (PCI)
- Impaired beliefs from literature
True/False When a part of your body is injured, special pain receptors convey the message to your brain? Pain only occurs when you are injured? The timing and intensity of pain matches the timing and number of signals in nociceptors?
- Fasle
Therapeutic neuroscience education
- neurophysiology of pain
- nociception and nociceptive pathways
- neurons
- synapses
- action potential
- spinal inhibition and facilitation
- peripheral sensitization
- plasticity of the nervous system
What not to include in patient pain education
- NO reference to anatomical or pathoanatomical models
- NO discussion of emotional aspect of pain
What to include in each session of patient pain education
- general goal of the session
- patient section
- image section - reinforce material
Patient education on nerves
- there are 45 miles of nerves in the body connecting all body parts
- at all times nerves have electrical activity flowing through them
- depending on many factors such as stress, movement, or temperature, the activity in nerves can go up or down
- nerves have thresholds & when nerves get excited enough to reach the threshold a message will be sent to your brain for analysis
- once the alarm is sounded and the messages goes to the brain, the alarm system should return to its resting state
Patient education on nociception & nociceptive pathways
- in one in four people the alarm system gets activated for the threat but then rests slightly below the firing level versus returning to its normal resting level
- the nerve is extra sensitive
- tissues heal & the longer pain persists, we know it is likely due to extra sensitive nerves in the area
- Prescriptions: membrane stabilizers & anti-depressants are designed to calm the nervous system
- calming the nervous system down requires education, blood flow, oxygen, and medication