placement 1 Pain Clinic Flashcards
CRPS
Complex regional pain syndrome
Test to aid in CRPS diagnosis
Budapest criteria
o Signs (OBJ) vs symptoms (SUB)
o Continuing pain, disproportionate to any inciting event
o At least 1 symptoms in ¾ of the categories
o At least 1 signs in 2 or more of the categories
o No other condition better explain the PC
UMN vs LMN lesion
Upper: brain and spinal cord
o Babinski, hoffmans
o Increased tone, reflexes, weakness
o Stroke, MS,
Lower: spinal cord -> muscles
o Decreased/normal tone, atrophy, reduced reflexes, weakness
o Peripheral nerve; could be due to central compression
What is Spondylosis
Arthritis of the spine
Myelopathy
o Compression of the spinal cord
o Likely disc changes, or central spinal stenosis
o Loss of balance and co-ordination, numbness, tingling, weakness, pain, loss of bowel or bladder function, difficulty walking, pain in low back, neck, arm/leg, clumsy gait,
o Symptomatic in a non-specific/non-dermatomal pattern -> mis-diagnose as Fibromyalgia
Stenosis
Narrowing of the space containing the spinal cord or where the nerve root exists the cord
/bony changes lead to nerve compression
Due to degen changes
AVN
Avascular necrosis
Disruption of blood flow to the head of femur
Femoral head pathology
Osteotomy
Bone cutting and reshaping surgery to restore function
Arthroplasty
Joint replacement surgery/impant
neuropathic meds (8)
Amitriptyline – headache, depression
Pregabalin & gabapentin – epilepsy, headache, anxiety
Morphine – opioid; not as effective when use alone, need combine
Oxycodone - opioid
Codeine – opioid; Often combined with acetaminophen, ibuprofen
Duloxetine – opioid, Depression, bladder problem
Tramadol – opioid; POWERFUL, only for ST
Capsaicin – intense burning sensation initial use
arthrodesis
joint fusing surgery
Vertigo
A Sx, rather than condition
RA - SCREEND’ EM (10)
o Skin changes – psoriasis
o IBS – inflammatory bowel disease
o Family Hx
o Painful red eye
o Early morning stiffness >30 mins
o Nails – pitting, thickening, painless detachment
o Swilling of the fingers
o Inflamed Achilles tendon, plantar fascia, patellar tendon
o Worse w REST, better with mvmt
o Response well to NSAIDs
Ways to desensitize the nervous system
(Name a few)
Meditation and mindfulness
Relaxation
Sleep
Diaphragmatic breathing
Exercises
Positive thoughts
Cold plunges
Weighted blankets
= Reduce stress
Ways to desensitize the nervous system
(Name a few)
Meditation and mindfulness
Relaxation
Sleep
Diaphragmatic breathing
Exercises
Positive thoughts
Cold plunges
Weighted blankets
= Reduce stress