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37 Cards in this Set
- Front
- Back
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visual analog scale
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Pain rating from 1-10
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Acute Pain
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Quick resolving pain from injury, inflammation, surgery, childbirth
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Chronic Pain
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Pain lasting longer than healing process
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Neuropathic Pain
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from diseases of or injury to the nerves
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Cancer Pain
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related to malignant disease or tumors effects on body
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Nociceptive Pain (2 types)
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Somatic Pain - localized sharp, aching, throbbing
Visceral - diffuse pain. Responds to NSAIDS, nerve blocks. |
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Neuropathic Pain
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due to nerve injury(ischemia, cutting)
Burning, tingling, stabbing, shooting, electrical Responds to interventional |
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Biological Process of Generating Pain
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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 |
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Treatments of Pain
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Can block transduction (lidocaine patch), transmission (nerve blocks), modulation (intrathecal), or modulate perception.
Non-invasive vs. Invasive Use step-wise treatment |
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Acute (Tendonitis)
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D: Inflammatory cell response with microtears & vascular degeneration
H: fibroblastic prolif, hemorrhage, granulation tissue Peritendonitis Periostitis |
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Chronic (Tendinosis)
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D: Degeneration w/o inflammatory
H: Collagen disorganization; focal necrosis and calcification; can see myofiroblasts Angiofibroblastic Hyperplasia |
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Overuse Tendinosis vs Overuse Tendinitis
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Tendinosis - longer recovery, less likely of recovery to sports, therapy = encourage collagen-synth and maturation & surgery to excise abnormal tissue
Teninitis - therapy = antiinflammatory |
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Paratenonitis
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D: Inflammation of outer layer of tendon
H: Mucoid degeneration in areolar tissue |
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Paratenonitis w/ Tendinosis
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D: Paratenonitis w/ intratendinous degeneration
H: collagen disorganization & mucoid |
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Tendonitis & Bursitis Symptoms
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Pain; aggravation; tenderness over area; pain w/ resised movements or compression
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Tendonitis & Bursitis Treatment
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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. |
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Functional Biochemical Deficit & Functional Adaptation Complex
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Biochemical - inflexibilities or imbalances that creat altered mechanics
Adaptation - substitutions used by patient |
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Lateral Epicondylitis
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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. |
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Hyperalgesia
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increased response to painful stimulus
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Allodynia
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Pain from stimulus that does not usually provoke pain
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Dysesthesia
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unpleasant abnormal sensation
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Hyperesthesia
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increasted sensitivity to stimulation
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Hyperpathia
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painful syndrome w/ increased rxn to stimulus, esp. repetative stimuli. there is an increased threshold.
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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. |
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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 |
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Sympathetically Maintained Pain (SMP)
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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. |
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Neurogenic Inflammation
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In CRPS, both axon reflex vasodilation and protein extravasation increases.
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Malingering
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intentional production of false or exaggerated conditions for external incentives
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Nociception
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activation of A-delta and C fibers indicating adverse effects usually associated w/ tissue damage
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Pain
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sensation arising from precieved nociception
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Acute Pain
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<6months
Your "Warning signal" Evidence for nociception Responds to analgesics Causes anxiety |
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Chronic Non-Malignant Pain
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>several months
No evidence of nociception or tissue damage No well response to analgesics Hopelessness and despair Diffuse pain Etiology idiopathic |
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Operant Conditioning
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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. |
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Pavlovian Conditioning
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bell --> bring food --> dog salivates
bell --> dog salivates |
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Cognitive Behavioral Therapy
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If injured people fear reinjuy and obtain disuse depression = viscious cycle.
CBT helps pts recognize behaviors and overcome fear & depression. |
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Self Efficacy
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High = one can manage challenging situation
Low = less likely to engage in adaptive coping behaviors TEACH SELF EFFICACY |
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Recommendations for LBP Treatment
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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 |
