Pain Phenotyping and Screening/Subjective (PPT 3&4) Flashcards
Characteristics of nociceptive pain (4)
-from noxious stimuli
-intermittent < 3 months
-distinct distribution
-improves with time
Characteristics of nocioplastic pain
-from non-noxious stimuli
-daily, >3 months or 50% d’s for 6 m’s
-regional, multifocal, widespread
-pain hypersensitivity
What is neuropathic pain
from disease or lesion of somatosensory NS
6 risk factors for nocioplastic pain
-disturbed sleep
-female
-early life stress/trauma/childhood experience
-increased somatic awareness
-hx chronic pain
What outcome measure is the gold standard for LBP
oswestry
List the constitutional symptoms (9ish)
-fatigue
-malaise
-wt loss
-nausea
-weakness
-fever/chills/sweats
-numb/tingle
-dizzy/lightheaded
-mentation/decreased cog
Red flags for L/S
-age >50
-bladder dysfxn
-hx cancer
-night pain
-hx trauma
-saddle anaesthesia
-wt loss
-LE neurologic deficit
-fever/chills
-recent infect
-immunosuppression
5 questions for triage (red flags)
-unexplained wt loss
-changes in gait
-new weakness
-changes in bowel/bladder
-unremitting night pain
Yellow flags
-depression
-fear avoidance
-other chronic pain inventories
Back related tumor red flags
- > 50 yo
-hx cancer
-unexplained wt loss
-failure conserv therapy
-night or rest pain
-symps of other system dysfxn
Back related infection red flags
-IV drug user
-recent infect
-concurrent immunosup. disorder
-signs of infect (fever, chills, cough, stiff neck, malaise)
Cauda equina syndrome red flags
-urine retention/incontinence
-fecal incont
-saddle anesthesia
-global or progressive weakness in LE
-sensory deficits in ft (L4-S1)
Nerve root for patellar reflex
L4
Nerve root for achilles reflex
S1
Nerve root for HS
L5
Myotomes for iliopsoas
L2-3
Myotomes for quads
L3-4
Myotomes for TA
L4
Myotomes for EHL
L5
Myotomes for glute med
L5
Myotomes for peroneals
S1
Myotomes for gastroc/soleus
S1-2
Myotomes for HS
S1
