Week 2: Features of Sensitisation Flashcards
What is the other name for central sensitisation?
Supraspinal sensitisation
The longer pain is experienced the weaker the relationship….
Between tissue damage and pain
From what direction is pain occurring in central sensitisation? What does this mean?
Top down (means the CNS is contributing to symptoms)
Is there still nociceptive input in pain that is experienced beyond the normal healing timeline for an injury?
The pain is less likely to have nociception as the dominant driver. There may be still be nociceptive input but this is now being upregulated by a sensitive CNS
Central sensitisation: Location
Shifting and spreading
Central sensitisation: Quality
Often difficult to describe (patients may use analogies)
Central sensitisation: Intensity
Severe/unpredictable ie movement may not necessarily make it worse
Central sensitisation: Behaviour
Unpredictable (it can fluctuate)
Central sensitisation: Duration
Does not ease quickly with rest
Central sensitisation: Clinical signs
Pain is not associated with an obvious mechanical driver eg standing at a dinner party doesn’t cause pain vs standing at a bus stop causes pain
From what direction is pain occurring in peripheral sensitisation?
Bottom up eg broken wrist (peripheral sensors are telling you that something is wrong)
If someone has injured their ankle or broken their arm (acute situation) the dominant driver will be a ……?
Peripheral one
Peripheral sensitisation: Location
Precise (closely associated with other signs of tissue damage)
Peripheral sensitisation: Quality
Sharp, blunt, dull, aching
Peripheral Sensitisation: Intensity
Worse with movement
Peripheral Sensitisation: Behaviour
Doesn’t spread
Peripheral Sensitisation: Duration
Eased quickly with rest
Peripheral Sensitisation: Clinical signs
Associated with an injury (within 3mths of an injury eg ankle sprain)
True of false: Pain will always be a combination of both peripheral and supraspinal (central) mechanisms - the key is to determine what the dominant driver is!
TRUE
Peripheral (nociceptive) pain - Somatic
- Location
- Quality
- Intensity
- Behaviour
- Duration
- Clinical signs
- Location: very specific and well-localised and precise
- Quality: Sharp
- Intensity: Severe (upper end of VAS)
- Behaviour: Associated with withdrawal reflex
- Duration: very short (doesn’t last long)
- Clinical signs: The immediate pain that is experienced due to a rapid mechanical stimuli (blow to the body), extreme hot or cold stimulus (hand on a hot plate) or chemical irritation)
