Lecture 9 Flashcards
(22 cards)
Neck pain with movement coordination impairments (wiplash)
associated w/ shoulder problems
Dizziness/nausea
Headache, concentration issues or memory difficluts
Confusioned
Heightened affective distress
Hypersensitivity to everything since they’re in that chronically sensitive state
Every little thing sets them off because they’re hypersneitive to everything (on high alert)
* thermal
* acoustic
* olfactory
* visual
* mechanical
Iritability very important to find
Would someone with a wiplash injury have an increased or decreased pain sentivity?
Increased - they’re hypersensititve to everything
doesnt take as much to bring on their symptoms
NOTE: Their neck pain is going to be present at mid range and end range (People w/ ROM issues only present w/ end range problems)
may have lots of trigger points
May look a lot like a cervicogenic HA except we have a MOI now
KNOW: Wiplash pts would proably have neck endurance muscle loss
KNOW: These pts would have proprioception problems. (swelling)
KNOW: We don’t really do much physical stuff to an acute whip lash pt
KNOW: Acute whiplash around 6 wks, subacute = 6-12
What does nociplastic mean?
Nociception (pain) despite no clear evidence of actual or threated tissue damage
Does acute pain always mean tissue damage w/ whiplash?
No, it might be nociplastic pain
Does chronic pain automatically mean nociplastic pain?
No, the tissue might still be damaged / irretated
How does neuropathic pain present in someone w/ a whiplash injury?
referred arm pain
What 4 intervention would you use w/ a pt that has nociceptive pain after whiplash?
Exercise
Massage
TENS
Manipulation
What interventions would you do w/ a nociplastic (more chronic) whiplash pt?
Education
EX
Massage
Manipulation
TENS
What would you do for a neuropathic whiplash pt?
EX
Poor WAD prognosis if their NDI score is above ______
Note: this is also an increased risk of presistent pain
30%
Poor WAD prognosis if their high pain intensity score is = to or greater than __/10
NOTE: this also is the same for an increased risk o presistent pain
6
KNOW: None of the things below affect prognosis for WAD
Angular deformity of the neck
Impact direction
Seating position in the vehicle
Awareness of impending collision
Having a headrest in place at the time of the collision
Stationary vs moving when hit (the car moving)
Older age - DOES NOT AFFTECT WAD
Should an acute WAD pt be wearing a soft collar?
No collar - theres no stufcutral damage - we need to get them to remain active, act as usual
KNOW: for someone w/ chronic WAD its best to find a psyco therapist to assest along w/ you
KNOW: We start throwing in endurance EX for subacute / longterm WAP injuries to try and reup those muscles
KNOW: Whenever a WAD has long term difficulties they stop moving their neck. We want to throw in vestibular work for someone w/ chronic WAD because they arent moving their neck which means they arent ever sitmulating their vestiular
KNOW: If pt is scared of pain w/ right shoulder flexion get them to work on left shoulder flexion. It will help those neuro pathways on both sides to form
What is graded exposure?
Doing some intervention that encourgaes moving into pain which they are fearful of
We start slowly
For EX: if picking something off the ground hurts start by going halfway down
