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TEX 3 > PRELIMS: Pain > Flashcards

PRELIMS: Pain Flashcards

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1
Q

Q: What is the difference between peripheral and central sensitization?

A

Peripheral sensitization: Increased responsiveness of nociceptors due to injury/inflammation.
Central sensitization: Amplified pain perception due to changes in the central nervous system (CNS).

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2
Q

Q: What is sympathetically maintained pain?

A

A: Pain that is sustained by the sympathetic nervous system, common in conditions like complex regional pain syndrome (CRPS).

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2
Q

Q: What is neuropathic pain?

A

A: Pain caused by damage or dysfunction of the somatosensory nervous system, often described as burning, shooting, or tingling.

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2
Q

Q: What is the neuromatrix theory of pain?

A

A: Pain is generated by a network of brain regions influenced by sensory, cognitive, and emotional factors, rather than just tissue damage.

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3
Q

Q: How does dry needling work for trigger points?

A

A: It causes a localized twitch response, releasing muscle tension and resetting neuromuscular function.

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3
Q

Q: What are common trigger points in myofascial pain syndrome (MPS)?

A

Upper trapezius – Shoulder and neck pain
Levator scapulae – Neck stiffness
Gluteus medius – Lower back pain
Quadratus lumborum – Side/lower back pain

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3
Q

Q: What are the key diagnostic criteria for fibromyalgia (FM)?

A

Widespread pain for >3 months
Pain in ≥4 of 5 regions (new criteria)
Associated symptoms: fatigue, poor sleep, cognitive issues

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3
Q

Q: How does catastrophizing affect chronic pain?

A

A: It amplifies pain perception by increasing emotional distress, leading to avoidance behaviors and disability.

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3
Q

Q: What are common environmental triggers for fibromyalgia flare-ups?

A

A: Weather changes (cold, humidity), stress, lack of sleep, and excessive physical activity.

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3
Q

Q: What are yellow flags in pain management?

A

Psychological factors that increase the risk of chronic pain:

Fear-avoidance behaviors
Pain catastrophizing
Low self-efficacy
Passive coping strategies

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3
Q

Q: What are the three main components of myofascial pain syndrome (MPS) treatment?

A

Correct chronic overload (postural changes, ergonomic fixes)
Eliminate trigger points (stretching, dry needling, manual therapy)
Strengthen muscles (gradual endurance training

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4
Q

Q: What are red flags for serious underlying conditions in chronic pain patients?

A

Unexplained weight loss (cancer)
Severe nocturnal pain (malignancy)
Bowel/bladder dysfunction (cauda equina syndrome)
History of trauma with sudden pain onset (fracture)

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4
Q

Q: What are blue flags in chronic pain?

A

A: Work-related factors, such as job dissatisfaction or the belief that work will cause further injury.

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4
Q

Q: What is graded motor imagery (GMI)?

A

A: A rehab technique that re-trains the brain’s pain perception using left-right discrimination, visualization, and mirror therapy.

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4
Q

Q: What are black flags in chronic pain?

A

A: Social and system-related factors like lack of insurance, workplace policies, and compensation claims.

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4
Q

Q: What are key components of cognitive behavioral therapy (CBT) for pain?

A

Pain education (understanding pain mechanisms)
Cognitive restructuring (challenging negative thoughts)
Graded exposure therapy (reducing fear of movement)
Relaxation techniques (breathing, mindfulness)

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5
Q

Q: What is the role of mindfulness meditation in pain management?

A

A: It helps reduce pain perception by improving focus on the present moment and reducing emotional reactivity.

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5
Q

Q: What is the difference between joint mobilization and manipulation?

A

Mobilization: Slow, controlled oscillatory movements within joint range.
Manipulation: High-velocity, low-amplitude thrust beyond the passive range.

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6
Q

Q: What is the purpose of traction in pain rehab?

A

A: To decompress spinal structures, relieve nerve root irritation, and improve joint mobility.

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7
Q

Q: What are contraindications for spinal manipulation?

A

Vertebral artery insufficiency
Acute fracture
Joint instability (e.g., rheumatoid arthritis)
Severe osteoporosis

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8
Q

Q: What is the role of cervical deep neck flexor training in chronic neck pain?

A

A: Strengthening the longus colli and longus capitis improves cervical stability and reduces pain.

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9
Q

Q: How does progressive muscle relaxation (PMR) help in pain management?

A

A: It reduces muscle tension and stress by systematically contracting and relaxing different muscle groups.

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9
Q

Q: What are progressions of core stabilization exercises for chronic low back pain?

A

Isometric activation (e.g., drawing-in maneuver)
Quadruped exercises (bird-dog)
Unstable surface training (Swiss ball exercises)
Functional movement training (lifting, squatting)

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9
Q

Q: What are effective self-care strategies for chronic pain?

A

Heat or ice application
Massage therapy
TENS (Transcutaneous Electrical Nerve Stimulation)
Hydrotherapy (water-based exercises)

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10
Q: What is the definition of pain?
A: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
11
Q: What are the six main goals of chronic pain rehab?
Reduce pain perception Improve function and mobility Enhance psychological well-being Promote active self-management Encourage physical activity and exercise Reduce medication dependency
12
Q: What are signs that a chronic pain patient is improving?
Increased movement without fear Less reliance on passive treatments Better mood and sleep patterns Greater participation in daily activities
13
Q: What are the different types of pain?
Nociceptive pain – Pain from actual or threatened tissue damage Neuropathic pain – Pain from nerve damage Inflammatory pain – Pain from immune response activation Central sensitization – Increased CNS responsiveness to pain signals
13
Q: How is acute pain different from chronic pain?
Acute pain is short-term and linked to tissue healing. Chronic pain lasts beyond expected healing time and may persist without clear cause.
14
Q: What is allodynia?
A: Pain caused by a stimulus that does not normally provoke pain (e.g., light touch).
15
Q: What is hyperalgesia?
A: Increased pain response to a normally painful stimulus.
16
Q: What is referred pain?
A: Pain felt in an area distant from its origin, often following nerve pathways.
16
Q: What is nociplastic pain?
A: Pain due to altered nociception, without clear evidence of tissue damage or nerve injury.
16
A: A model recognizing that pain is influenced by biological, psychological, and social factors.
Poor social support Anxiety and depression Fear-avoidance behaviors Pain catastrophizing
17
Q: What is the biopsychosocial model of pain?
A: A model recognizing that pain is influenced by biological, psychological, and social factors.
17
Q: Why is pacing important in exercise therapy for chronic pain?
A: To avoid flare-ups and ensure sustainable progress without overexertion.
17
Q: What are the recommended exercises for chronic pain patients?
Aerobic exercise (walking, swimming, cycling) Strength training (light resistance exercises) Stretching and mobility exercises
17
Q: How does exercise help in chronic pain management?
Provides exercise-induced analgesia Improves mobility and strength Reduces fear-avoidance behaviors Enhances quality of life and mood
17
Q: What are common non-pharmacological pain management techniques?
Exercise therapy Manual therapy Cognitive behavioral therapy (CBT) Relaxation strategies (breathing, mindfulness)
17
Q: How does stress affect chronic pain?
A: Stress increases pain perception by heightening muscle tension and altering pain processing.
18
Q: What are key principles of chronic pain management?
Pain neuroscience education Physical reconditioning through exercise Psychological support (e.g., CBT) Sleep improvement strategies Lifestyle modifications
18
Q: What is the role of graded exposure therapy in pain management?
A: Gradually exposing patients to feared activities to reduce fear-avoidance behaviors.
19
Q: What are the benefits of manual therapy for pain?
Reduces muscle tension and stiffness Improves joint mobility May provide short-term pain relief
20
Q: What is the risk of dependency on manual therapy?
A: Patients may over-rely on passive treatments, reducing their motivation for active rehab.
21
Q: What is fibromyalgia?
A: A chronic pain condition characterized by widespread pain, fatigue, and sleep disturbances.
22
Q: What are common symptoms of fibromyalgia?
Chronic muscle pain Fatigue and poor sleep Cognitive issues (“fibro fog”) Tender points across the body
23
Q: What is myofascial pain syndrome (MPS)?
A: A regional pain disorder characterized by trigger points in muscles.
24
Q: What is dry needling?
A: A technique using thin needles to release trigger points and reduce muscle tension.
25
Q: What are the key techniques in dry needling?
Travell & Simons technique: Precise needling of trigger points Hong’s technique: Fast pecking to elicit multiple twitch responses Gunn’s technique: Deep needling along the muscle length
26
Q: What are precautions for dry needling?
Avoid in pregnant women and cancer patients Be cautious with bleeding disorders and pacemakers Do not use near nerves or vital structures
27
Q: What are effective cervical stretching techniques for pain relief?
Chin tuck (cervical retraction) – Strengthens deep neck flexors Scalene stretch – Reduces tension in lateral neck muscles Upper trapezius stretch – Relieves neck and shoulder stiffness
28
Q: How can thoracic extension be improved?
Foam rolling along the thoracic spine Seated thoracic extension stretch Wall angels to activate thoracic mobility
29
Q: What are grades of spinal mobilization?
Grade I & II – Small oscillations for pain relief Grade III & IV – Large oscillations for mobility improvement Grade V (HVT) – High-velocity thrust to restore joint movement
30
Q: What are contraindications for cervical manipulation?
Vertebral artery disease Acute joint inflammation History of fracture or ligamentous instability
31
Q: How does CBT help in pain management?
Changes negative pain-related thoughts Encourages active coping strategies Reduces pain catastrophizing
32
Q: What are CBT techniques for pain relief?
Cognitive restructuring – Changing negative pain beliefs Pacing strategies – Avoiding overactivity-rest cycles Relaxation techniques – Deep breathing, mindfulness
33
Q: What are the goals of pain rehabilitation?
mprove physical function Reduce pain perception Enhance quality of life
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TEX 3 (12 decks)

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