Pain Evaluations and Interventions

Question 1

how is pain multifactorial?

Answer 1

Past pain experience
mood
cultural influences
gender differences
lower SES
children/elderly

Question 2

what is acute pain?

Answer 2

Predictable, treatable
e.g. sprains, strains, cuts, fractures

Question 3

what is chronic pain?

Answer 3

Unpredictable, difficult to treat
e.g. neurological conditions, CRPS

Question 4

what does medical management consider in terms of pain?

Answer 4

• acute vs persistent (chronic) vs
  acute crises of chronic pain (e.g.
  exacerbations or “flare-ups”)
• Reason for the pain e.g.
  neurological, MSK, cancer
• Previous medication

Question 5

how can we report pain?

Answer 5

Because pain is subjective, self-report
measures provide the most valid measure of the experience.

• Visual Analog Scale
• Numerical Rating Scale
• Verbal Rating Scale
• Wong-Baker FACES Pain Rating Scal

Question 6

what are common pain behaviours?

Answer 6

guarded movement, co-
contraction, posturing, facial grimacing

Question 7

how can we evaluate pain in infants?

Answer 7

objectified with increased cortisol
levels, increased heart rate

Question 8

ow does pain affect stress and mood?

Answer 8

*Pain activates sympathetic nervous
system

• Stress associated with ADLs can trigger pain

Question 9

what should pain interventions focus on?

Answer 9

occupational performance, role recovery (if lost), quality of life

Question 10

what are some OT interventions for pain?

Answer 10

Help client to understand:
* Nature of pain
* Multiple and interrelated factors
affecting pain (physical, cognitive,
psychosocial)
* Pain diary—patient instructed to
maintain for 1 to 2 weeks *may be
helpful for acute pain; often used
for persistent pain
* OT & client identify patterns of
pain related to multiple factors

Recognize the importance of sleep!:
* Sleep Patterns—problems include
difficulty falling asleep, frequent
awakenings, insufficient total
sleep time (7–8 hrs

Question 11

what are body mechanics?

Answer 11

Proper positioning of body
during daily activities to avoid injury and pain

Question 12

what are the general principles of proper body mechanics?

Answer 12

• Maintain straight back and upright posture
• Carry objects close to body
• Lift with lower extremities, maintain wide base of support
• Avoiding spine rotation and compression movements

Question 13

what is energy conservation?

Answer 13

Reducing energy expenditure in an activity and arrangement of desired ADLs over day or week for purpose of:

• Preserving patient stamina,
• Preventing fatigue, and
• Minimizing joint stress and pain

Question 14

what is work simplification?

Answer 14

arrangement of tools and steps in an activity to reduce amount of energy expended

Question 15

what is critical to managing pain?

Answer 15

pacing

Question 16

what are general guidelines for Energy Conservation and Work Simplification?

Answer 16

Plan activities for each week to avoid completing too many in 1 day.
* Pace needed activities for each day so that rest periods are maintained between activities.
* Maintain a slow and steady pace; avoid rushing.
* Break large tasks into smaller ones that can be divided throughout day.
* Maintain all supplies for daily activities in location where each activity is to take place.
* Sit whenever possible, but avoid prolonged sitting.
* whenever feasible, use guide of 20 minutes sitting, 8 minutes standing, and 2 minutes walking

Question 17

what are Physical Agent Modalities?

Answer 17

interventions and technologies that use force or energy to promote healing process and reduce
pain

Question 18

what are some Modalities commonly used in acute and chronic pain?

Answer 18

• Hot & cold packs
• Transcutaneous electrical nerve
  stimulation (TENS)
• Biofeedback