UNIT 3: Wk 2: Pain Interventions Flashcards
What are the two intervention approaches to help with pain?
- education
- graded exposure
Top Down approach to intervention
Cognitive based interventions
- educate about pain neuroscience
- graded motor imagery
- cognitive behavioral therapy (CBT)
- mindfulness meditation
Bottom Up approach to pain interventions
Physical interventions
- manual therapy
- motor learning
- peripheral discrimination training
Biopsychosocial approach
Looks at whole person - pain happens between biological, psychological, and social
Recognize threat (fear, aging, etc )
Cognitive behavioral therapy
Thoughts, emotional responses, psychological and behavioral responses interact and influence one another
- strategies to change patterns of thoughts and regulate emotions
- cope more effectively with pain and stressors
CBT Phases
- Assessment
- Reconceptualization (largest portion)
- Skill acquisition
- Skill consolidating and application training
- Generalization and maintenance
- Post treatment assessment and follow up
CBT influence in PT
- WE become more aware of our perceptions of how we view pt
- listening to understand— not to drop an answer
- teach breathing focus, relaxation, affirmations, distraction, self manage mood and pain
Pain Neuroscience Education
Trying to eliminate the perception of danger that the patient is experiencing
- people want to learn about their pain — not anatomy and biomechanics
- actual pain science
T or F: education is therapy
TRUE — don’t say “their pain is in their head”
Advice for pts
- do aerobic activity (brisk 10 min walk) LOG ACTIVITIES
- sleep hygiene (8hrs)
- medicine - antidepressants ‘
- goals and packing- break tasks up into achievable chunks
Mindfulness Meditation
- ## non elaborative, non judgmental awareness of thought, feelings, behaviors
Focused attention mindfulness meditation
Usually focus on breathing
Open monitoring mindfulness meditation
Non focused, open minded awareness
- letting mind go - just letting go
Mechanisms of Mindfulness Meditation
- enhance cognitive and emotional control
- altered contextual evaluation
- change attention, emotional response, and acceptance and coping to pain
T or F: you can tap into parasympathetic nervous system via breath control
True
Graded motor imagery
- brain exercise that works at synaptic level to restore map of body in brain
It reorganizes body schema, self awareness, acceptance, self perception
Progression of GMI
Low threat to high threat
Observation watching activities —> L/R judgements —> Imagining movements —> mirror —> physical movements/activities
Laterality recognition
Ability to distinguish R from L (of the body part in pain)
- starts as low threat images in relaxed positions then goes to higher threat (more painful position)
- 2x/day
Requires metal and special recognition
*ppl can be slower recognizing and can have pain during this
Motor Imagery
Asking the person to imagine themselves moving and feeling themselves moving
- 2x/day
Progression: low threat - posting position and still; high threat - painful position or movement/activity
Mirror therapy
Trick the brain by replacing the injured part and seeing the body part moving without the pain
“Retraining the brain to experience”
Bottom up intervention
Try to remap the cortex using input from body
Sensory discrimination training & what type of pt
Aims to reverse cortical reorganization (neuroplasticity) - doesn’t require any movement
Sharp/dull; sensation testing
- for patients w high pain levels and decreased tactile acuity
