Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
visual analog scale
|
Pain rating from 1-10
|
|
Acute Pain
|
Quick resolving pain from injury, inflammation, surgery, childbirth
|
|
Chronic Pain
|
Pain lasting longer than healing process
|
|
Neuropathic Pain
|
from diseases of or injury to the nerves
|
|
Cancer Pain
|
related to malignant disease or tumors effects on body
|
|
Nociceptive Pain (2 types)
|
Somatic Pain - localized sharp, aching, throbbing
Visceral - diffuse pain. Responds to NSAIDS, nerve blocks. |
|
Neuropathic Pain
|
due to nerve injury(ischemia, cutting)
Burning, tingling, stabbing, shooting, electrical Responds to interventional |
|
Biological Process of Generating Pain
|
Transduction (nerve endings --> dorsal horn)
Transmission (dorsal horn --> spinothalamic --> thalamus) Modulation (thalamus --> cortex --> descending pathways) Cortex percieves stimuli --> CREATES pain sensation --> inhibits thru decsending --> activates withdrawl spinthalamic = stim path descending = inhibitory |
|
Treatments of Pain
|
Can block transduction (lidocaine patch), transmission (nerve blocks), modulation (intrathecal), or modulate perception.
Non-invasive vs. Invasive Use step-wise treatment |
|
Acute (Tendonitis)
|
D: Inflammatory cell response with microtears & vascular degeneration
H: fibroblastic prolif, hemorrhage, granulation tissue Peritendonitis Periostitis |
|
Chronic (Tendinosis)
|
D: Degeneration w/o inflammatory
H: Collagen disorganization; focal necrosis and calcification; can see myofiroblasts Angiofibroblastic Hyperplasia |
|
Overuse Tendinosis vs Overuse Tendinitis
|
Tendinosis - longer recovery, less likely of recovery to sports, therapy = encourage collagen-synth and maturation & surgery to excise abnormal tissue
Teninitis - therapy = antiinflammatory |
|
Paratenonitis
|
D: Inflammation of outer layer of tendon
H: Mucoid degeneration in areolar tissue |
|
Paratenonitis w/ Tendinosis
|
D: Paratenonitis w/ intratendinous degeneration
H: collagen disorganization & mucoid |
|
Tendonitis & Bursitis Symptoms
|
Pain; aggravation; tenderness over area; pain w/ resised movements or compression
|
|
Tendonitis & Bursitis Treatment
|
1)diagnose
2)PRICE - Protection; relative rest; ice; compression; elevation. (& anti-inflams) 3)eccentric strenghthening & closed kinetic chain exercises Steroids are controversial. side effects = psychosis, ulcers, avascular necrosis, diabetes, necrosis (w/injection), and injectables not always reabsorbed. |
|
Functional Biochemical Deficit & Functional Adaptation Complex
|
Biochemical - inflexibilities or imbalances that creat altered mechanics
Adaptation - substitutions used by patient |
|
Lateral Epicondylitis
|
Tennis Elbow
-extensor tendons insert at lateral epicondyles -involves more than tendon -tender to palpation -pain w/ gripping, wrist & middle finger extension Treat w/ PRICE, NSAID, ROM, steroids,surgery. |
|
Hyperalgesia
|
increased response to painful stimulus
|
|
Allodynia
|
Pain from stimulus that does not usually provoke pain
|
|
Dysesthesia
|
unpleasant abnormal sensation
|
|
Hyperesthesia
|
increasted sensitivity to stimulation
|
|
Hyperpathia
|
painful syndrome w/ increased rxn to stimulus, esp. repetative stimuli. there is an increased threshold.
|
|
Complex Regional Pain Syndrome
Type 1 |
Reflex Sympathetic Dystrophy
Noxious event --> spontaneous pain or allodynia / hyperalgesia, multiple nerve areas, edema, skin blood flow or sudomotor abnormality Can have viscious circle of nociceptor input activating multiple autonomic/somatic actions. |
|
Complex Regional Pain Syndrome
Type II |
Causalgia
**Nerve injury** --> spontaneous pain or allodynia/hyperalgesia, not necessarily limited to nerve territory, edema, skin blood flow and sudomotor abnormalities. Has SMP |
|
Sympathetically Maintained Pain (SMP)
|
A consequence of Causalgia.
Cutaneous nociceptors of damabed nerve become excited by sympathetic efferents (NE) because of possible dennervation hypersensitvity and upregulation of NE receptors. |
|
Neurogenic Inflammation
|
In CRPS, both axon reflex vasodilation and protein extravasation increases.
|
|
Malingering
|
intentional production of false or exaggerated conditions for external incentives
|
|
Nociception
|
activation of A-delta and C fibers indicating adverse effects usually associated w/ tissue damage
|
|
Pain
|
sensation arising from precieved nociception
|
|
Acute Pain
|
<6months
Your "Warning signal" Evidence for nociception Responds to analgesics Causes anxiety |
|
Chronic Non-Malignant Pain
|
>several months
No evidence of nociception or tissue damage No well response to analgesics Hopelessness and despair Diffuse pain Etiology idiopathic |
|
Operant Conditioning
|
Noxious stimulus <--> Pain behavior <--> reinforcement
If people get reinforced for pain behavior, theory suggests behavior continues even w/ no pain! Reinforcements(Chronic Pain): avoidance of undesirable taskes, more attention, opiods, etc. |
|
Pavlovian Conditioning
|
bell --> bring food --> dog salivates
bell --> dog salivates |
|
Cognitive Behavioral Therapy
|
If injured people fear reinjuy and obtain disuse depression = viscious cycle.
CBT helps pts recognize behaviors and overcome fear & depression. |
|
Self Efficacy
|
High = one can manage challenging situation
Low = less likely to engage in adaptive coping behaviors TEACH SELF EFFICACY |
|
Recommendations for LBP Treatment
|
a. Beneficial Treatments: exercise therapy, behavioral therapy, multidisciplinary programs
b. Likely to be Beneficial Treatments: analgesics, back schools in occupational settings, massage (including OMT), and NSAIDS c. Unlikely to be Beneficial: bed rest, EMG biofeedback d. Ineffective or harmful: facet joint injections, traction |