Regional Pain syndrome Flashcards
Study of the indl in the work environment => TX is to modify the environment to minimize potential problems
ERgonomics
Overuse syndromes
Due to mictotrauma
Clinical Characteristics of Myofasical Pain sydrome
Trigger point, Taut band , Local twitch response
5 MAjor criteria to diagnose MPS
1PAin complaint or altered sensation in the expected distribution - zone of reference
2 Regional Pain Complaint
3 PAlpable taut bond J=(job sign) twitching upon palpation
4 Exquisite spot tenderness at one point along the length of the muscle
5 some restricted range of motionm as measurable
3 minor criteria for mps
1 Reproduction of pain or altered sensation on pressure on tender spot
2 Local twitch response elicited by snapping palpation or needling into tender spots
3 PAin Alleviated by stretching the musle or injecting the tender spot
Associated symtoms in MPS
DEpression, cold weather, sleep distrubances
Fibromyalgia (Clinical Characteristics)
1 Widespread pain and tenderness
2 TEnderpoints on digital Palpation (atleast 11)
3 sleep distrubance
4 associated symtoms (fatigue, sx with increasing number of areas involved and chronicity of pain)
2 mechanisms of FM
Peripheral - muscle microtrauma
Central - increased serotonin, higher risk of derpession, Hyperalgesia
RX for MPS (pharmacologic)
Muscle relaxants,NSAIDS (LOCAL) GEneralized (FM) 1. TCA 2. Anticonvulsants 3. SNRI
Physical Modalities for Physical therapy
- deep heat, electrotherapy, MAssage,Neuromuscular reeducation, Aerobic exercise
anterior shoulder pain aggeavated by overhead activity caused by tendinitis of the rotator cuff
shoulder impingement syndrome
Types of stabilizers
Static (glenoid, labrum, gh and joint capsule) Dybanic STabilizers (musces) Rotator cuff, biceps tendon
Conditions that might controbute to Shoulder Impingement syndromes
DM, cervical spine disorders, if bilateral shoulder pain (Think RA)
PAinful arc
70-100 degrees most commonly affected
NEer’s test
Fix scapila with one hand then flex the shoulder with the other reproduces pain
Surgical tx for SIS
subacromial decompression, resection arthroplasty, athryoscopy
Goal is to increase space between acromion and the rotator cuff
Speed’s test
Pain at bicipital groove on resisted shoulder flexion at 80-90 degrees
Popeye muscle
Bicipital tendinitis
Surgerical tx for Bicipital Tendinitis
ACromioplasty, biveps tenodesis
PRedisposing gactors of Adhesive capsulitis
Immobility, 40 - 60 yrs old, female, thyroid disease
Due to overuse of the wrist in extension or flexion
Epicondylitis
Affects origin of the extensor carpi radialis brevis and longus, extensor digitorum, extensor carpi ulnaris, supinator
tennis elbow (lateral epicondylitis)
Exams for Tennis elbow
Middle finger test, Cozen’s test
Tx for severe chronic cases of LAterla epicondylitis
Platelet rich plasma injections
Inflammation of the tendon sheath of the abducgtor pollicis longus, extensor pollicis brevis at hte lateral bords or the anatoimic snuffbox
De Quervain’s Tenosynovitis
TX for D Q Tenosynovitis
Thumb spica splint, surgical release
Due to enlargement of tendon or thickening of the pulley (nodule)) u to 3-4 X normal size
Trigger FInger
Due to intraneural ischemia decreased blood flow to the nerve
CTS
Causes of low back pain
MEchanical Low back pain
OA
Degenerative DIsc disease