W7 Flashcards
What is referred pain?
Pain perceived in a region topographically displaced from the region of the source of the pain
Convergence projection mechanism of referred pain
Occurs when afferent neurons form different parts of the body converge at a common neuron. Pain may be experienced in any of these other parts of the body innervated by the other neurons.
What are the timeframes for classification of spinal disorders?
Acute: <6 weeks
Subacute: 6-12 weeks
Chronic: >12 weeks
What are the three main things to consider when assessing spinal pain?
- Red flag disorders
- Specific spinal pain
- Non-specific spinal pain
What are some red flag disorders of spinal pain?
- Cancer
- Inflammatory disorders
- Infections
- Fractures
- Visceral pathology
What constitutes as specific spinal pain?
Pain occurring from clear spinal pathology, where imaging correlates with presentation
- Disc pathology
- Radiculopathy
- Facet Jt pathology
- Stenosis
- Spondylosis
- Spondylolisthesis
What constitutes as non-specific spinal pain?
Pain with no clear patho-anatomical diagnoses. Base assessment on elimination of specific pathology and red flag disorders. May have nociplastic involvement.
What are some features of non-specific spinal pain with non-mechanical/nociplastic symptoms?
- Lack of clear and consistent anatomical source
- Constant pain
- Spontaneous pain with no clear aggs
- Disproportionate pain
- Potential psycho-social/lifestyle contributing factors
What are some features of non-specific spinal pain with mechanical symptoms?
- Clear and consistent anatomical focus
- Proportionate mechanical behavior
- Potential maladaptive beliefs and behaviors as contributing factors
What are the goals of a physical examination of the spine?
- Identify relevant impairments
- Identify source of symptoms
- Identify main pain type
- Identify contributing factors
- Identify main problems
- Confirm or refute hypothesis
When to complete segmental neurological assessment
- Pins and needles
- Numbness
- Weakness
- Pain distribution or nature consistent with neural compromise
What is the likely pathobiology in spinal pain?
- Inflammation
- Acute trauma
- Post surgery
- Ligament damage
- Muscle damage
- Nerve damage
What are the components of muscle system assessment in the spine?
- Length
- Strength
- Endurance
- Control
- Timing
What are the components of the manual examination in the spine?
- PAIVMs
- PPIVMs
- AROM (add overpressure if no pain)
- Neurosegmental examinations
- Neurodynamics
- Special tests
What are the indications for imaging of spinal pain?
- Significant trauma
- Elderly
- Red flags
- Recurrent/persistent problems
- When findings will likely change or influence management
