PAIN too and Motor Flashcards
Stimulation of the Sympathetic Nervous System doesn’t usually cause pain, but there is a link between the SNS and what?
Chronic Pain.
When abnormal sympathetic activation occurs, what does that do to pain sensations?
Increases severity of pain and exaggerated sympathetic responses.
Define CRPS–Complex Regional Pain Syndrome
Severe pain out of proportion to injury, hyperesthesia, skin texture and color changes, hyperhydrosis, edema, stiffness and decreased hair growth.
May require medication or surgery to block the sympathetic output.
What is the best paper questionaire to measure pain?
Visual Analog Scale. VAS. and Numeric Scales.
Pain charts are good too (body diagrams)
What are 7 Pharmocotherapeutics for pain?
NSAIDS (non-steroidal anti-inflammatory)
Acetaminophen.
Opiates (narcotics, oxycotin)
Antidepressants (Chronic pain)
Spinal analgesia (injection in the spine)
Local injections (Lydocaine injected in the painful area)
Sympathetic blocks (for CRPS–injected near sympathetic ganglion to block the pain.)
What is neural tension?
Nerves not moving properly within nerve sheath.
Non-pathological motion restriction
Soft tissue distention–Calf stretch–only 5 degrees of dorsiflexion, achiles tendon, gastroc/soleus complex are too tight to get to 10 degrees.
Bone or soft tissue approximation–the tissues are bumping into each other.
Define Capsular pattern
Define Non-Capsular pattern
The jt capsule causes the problem and has a pattern throughout the jt.
Has a pattern, but does not follow a capsular pattern.
What are Contractile (4) and Noncontractile sources of motion restriction?
Contractile--Muscles Muscle Musculotendinous jct. Tendon Tendinous interface w/ bone
Noncontractile–Everything else that isn’t muscle.
Intervention w/ Physical Agents to Address Motion Restriction
Increase soft tissue extensibility
Control Inflammation and Adhesions
Control Pain during stretching
Facilitate Motion
Superficial and deep heating agents (skin loosens, collagen loosens)
Cryotherapy–(inflammation is necessary, but painful. Can also be controlled with compression and elevation.)
Thermotherapy, cryotherapy, and electrical current. (sometimes pain restricts the mvt. Use a gating mechanism, usually bottom up [non-nociceptive])
Electrical stim, aquatic therapy (causes bicep to flex through e-stim.)
What is Edema?
SWelling…fluids are moving from where they’re suppoed to be (in capillaries) to where they aren’t supposed to be (surrounding the tissues)
How is normal fluid equilibrium maintained?
The balance between hydrostatic and osmotic pressure inside and outside blood vessels.
Define Hydrostatic pressure and what drives the process
BP and gravity.
Fluids move from high to lower pressures (inside capillary to outside)
Define Osmotic pressure and what drives the process.
Protein concentrations inside and outside capillaries.
Fluids move toward higher concentration of proteins (outside capillary to inside.)
‘what happens if hydrostatic or osmotic pressure gets messed up?
Edema happens.
