flashcards from articles
What is the neuromatrix theory of pain?
A theory that pain is generated by a ‘neurosignature’ within a brain network (body-self neuromatrix), not just from injury.
What is a neurosignature?
A pattern of neural activity that produces the pain experience, influenced but not caused by sensory input.
What are the main brain structures involved in the neuromatrix?
Thalamus, cortex, and limbic system.
How does the neuromatrix explain phantom limb pain?
It shows that pain can be felt without any physical input, as it is generated by the brain.
What role does stress play in chronic pain according to Melzack?
Stress activates hormonal responses (e.g., cortisol) that can damage tissues and contribute to pain.
What are the four key conclusions from the neuromatrix model?
1) Body is felt due to brain processes; 2) Pain can exist without input; 3) The self is unified; 4) Brain patterns are genetically programmed.
What are the three stages of tendinopathy in the continuum model?
Reactive tendinopathy, tendon dysrepair, and degenerative tendinopathy.
What happens in reactive tendinopathy?
Swelling due to acute overload, with increased proteoglycans and water—reversible with load management.
What defines the degenerative stage of tendinopathy?
Irreversible changes like matrix disorganization and cell death, often without pain.
Why might tendon structure and pain not align?
Many people show structural changes without pain; pain is influenced by load-related signaling.
What is reactive-on-degenerative tendinopathy?
A new reactive flare-up on an existing degenerative tendon.
What does the quote ‘treat the doughnut, not the hole’ mean in tendinopathy?
Focus on strengthening the healthy part of the tendon, not the degenerated portion.
What is the key idea of Bialosky’s updated MT model?
MT relieves pain through neurophysiological responses, not just mechanical correction.
What are the three zones in the MT mechanism model?
Zone 1: Provider-patient interaction; Zone 2: Nervous system response; Zone 3: Clinical outcomes.
How can MT alter pain processing in the nervous system?
Via peripheral, spinal, and supraspinal effects, including fMRI evidence of reduced brain activation in pain regions.
What are two psychophysical tools used to assess pain modulation?
Conditioned Pain Modulation (CPM) and Temporal Summation.
What makes MT effects patient-specific?
Patient beliefs, expectations, and provider interaction all influence outcomes.
Why might people resist identifying as ‘patients’?
It can feel disempowering and reduce their perceived value in care settings.
What is the significance of the ‘8760 hours’?
Most people manage their condition themselves outside the few hours spent with a provider.
How can providers better engage patients?
By asking about their life, validating their efforts, acknowledging loss of control, and practicing empathy.
What is a key critique of patient-centered care in this article?
Systems often focus more on procedures than truly seeing and respecting the person.
How should exercise for OA be tailored?
To the patient’s needs and preferences.
When is aquatic exercise recommended for OA?
If land-based exercises are too painful.
