S3L3: Catastrophizing to PT Mx Flashcards
(120 cards)
1
Q
What are the 4 sx of Catastrophizing?
A
Pessimism, helplessness to control Sx,
magnification, & rumination
2
Q
Identify: repetitive thinking or dwelling on
negative feelings & distress & their causes &
consequences
A
Rumination
3
Q
Modified T/F
Catastrophizing is the strongest & most consistent psychosocial factor for pain intensity & function. “This pain has destroyed my life” is an example of grieving.
A
T F
“This pain has destroyed my life” is an example of Catastrophizing.
4
Q
“I know there is something terribly wrong with me”
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
A
5
Q
“ I can’t stop thinking about how much it hurts”
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
A
6
Q
“I can’t stand this anymore”
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
A
7
Q
Very common comorbidity with chronic pain
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
B
8
Q
How many percent of pts c depression experience chronic pain?
A
13-85%
9
Q
Can be caused & cause the pain
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
B
10
Q
Associated with increased activity in portions of the
brain that mediate the affective component of pain
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
B
11
Q
Modified T/F:
Those that suffer from depression may grieve for their loss of identity, job, relationships, or hobbies. These pts can’t work properly d/t pain, loss relationships with other people, or pain may be preventing them from doing things they like/enjoy doing.
A
T T
12
Q
Modified T/F:
Chronic stress may produce analgesia. Stress-induces analgesia works through both opiate & non-opiate mediated mechanisms via descending inhibition.
A
F T
Acute stress
13
Q
Prolonged psychological or physiological stress leads to
a dysfunctional response with excessive immune system suppression, muscle atrophy, compromised tissue growth & repair, autonomic dysfunction, cognitive
changes & structural changes in the brain
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
C
14
Q
beneficial for people in certain amounts,
however prolonged amount of stress is not
beneficial already because it causes dysfunction in
the brain & CNS
a. Catastrophizing
b. Depression & Grieving
c. Stress
A
C
15
Q
Modified T/F:
Stress mediated peripheral & central sensitization
involves the activation of the autonomic nervous system
& the HPA axis. Acute pain aggravates stress when pts feel blamed or labeled as complainers especially when multiple tests do not identify a source of the pain, or when treatment is ineffective
A
T F
Chronic pain
16
Q
Modified T/F:
Pain is objective. Experience or perception of pain will differ from patient to patient.
A
F T
subjective
17
Q
Identify: The fifth vital sign
A
Pain
18
Q
Modified T/F:
Pain should be examined at rest only. Visual analogue scale & Numeric rating scale is best to use for examination of pain
A
F T
Pain should be examined both at rest & during movement
19
Q
Modified T/F:
Body diagrams provide information about pain location, radiation, & character. Sclerotomes, referred pain, dermatomes, & peripheral nerve patterns all implicate specific structures whereas symmetrical patterns of autonomic Sx implicate peripheral neurogenic involvement
A
T F
central neurogenic involvement
20
Q
Enumerate: PQRST mnemonic for Pain
A
Provoking/Precipitating factors
Quality of pain
Region & Radiation
Severity of associated Sx
Temporal factors/timing
21
Q
Enumerate: SOCRATES mnemonic for Pain
A
Site
Onset
Character
Radiation
Association
Time course
Exacerbating/ relieving
Severity
22
Q
Where is the pain
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
A
A
23
Q
When & how did it start?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
A
B
24
Q
Sudden or gradual?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
A
B
25
Trauma, illness, or other possible cause?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
B
26
how does the pain feel?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
C
27
Stabbing? Burning? Aching? Other?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
C
28
Other Sx, such as numbness,
paresthesias, heaviness, other?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
E
29
How does the pain vary over the day?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
F
30
Morning, evening, after activity or work
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
F
31
What aggravates or relieves the pain?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
G
32
Intensity rating
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
H
33
Does the pain radiate? Where? What causes the radiation?
a. Site
b. Onset
c. Character
d. Radiation
e. Association
f. Time course
g. Exacerbating/ relieving
h. Severity
D
34
Sensory, affective-emotional, evaluative, & temporal aspects of pain
a. McGill Pain Questionnaire
b. Leads Assessment of Neuropathic Signs & Sx
c. Neuropathic Pain Scale
d. The Initiative of Methods, Measurements & Pain
Assessment in Clinical Trials
A
35
Neurogenic vs Nociceptive pain
a. McGill Pain Questionnaire
b. Leads Assessment of Neuropathic Signs & Sx
c. Neuropathic Pain Scale
d. The Initiative of Methods, Measurements & Pain
Assessment in Clinical Trials
B
36
Neuropathic vs non-neuropathic
a. McGill Pain Questionnaire
b. Leads Assessment of Neuropathic Signs & Sx
c. Neuropathic Pain Scale
d. The Initiative of Methods, Measurements & Pain
Assessment in Clinical Trials
C
37
1. Pain
2. Physical functioning
3. Emotional functioning
4. Patient rating of improvement & satisfaction with
treatment
5. Other Sx & adverse events during treatment
6. Patient demographics
a. McGill Pain Questionnaire
b. Leads Assessment of Neuropathic Signs & Sx
c. Neuropathic Pain Scale
d. The Initiative of Methods, Measurements & Pain
Assessment in Clinical Trials
D
38
Enumerate: 6 parts of The Initiative of Methods, Measurements & Pain
Assessment in Clinical Trials
1. Pain
2. Physical functioning
3. Emotional functioning
4. Patient rating of improvement & satisfaction with
treatment
5. Other Sx & adverse events during treatment
6. Patient demographics
39
Modified T/F:
Narrative Information is often obtained verbally during history taking or
while talking during interventions. As much as possible try to get as much information
from pt regarding pain.
T T
40
Modified T/F:
Weeping, avoidance of eye contact are verbal information. Other behaviors that show relation to pain are non-verbal information.
F T
non-verbal
41
Modified T/F:
There is no general imaging or laboratory tests for chronic pain. Positive finding on images prove that the identified pathology is related to the Pt.'s pain.
T F
do not prove
42
Modified T/F:
Repeated diagnostic imaging advisable. Lab tests such as thyroid hormone testing,
Sedimentation rates, Lyme titers, or general blood screening, can be appropriate to rule out conditions that are treatable.
F T
is not
43
Modified T/F:
EMG is not indicated unless there is suggestion of
specific neuropathies. Diagnostic nerve blocks (peripheral or sympathetic), joint
blocks (facet or sacroiliac), & provocative discography can help determine whether a specific structure is involved.
T T
44
Acetaminophen
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
A
45
Most type of pain
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
A
46
Liver Toxicity
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
A
47
Naproxen,
salsalate,
etodolac,
ibuprofen,
disclofenac
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
B
48
Nociceptive,
inflammatory
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
B
49
GI Bleeding,
nausea, cardiac
risk
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
B
50
Capsaicin,
lidocaine,
salsalate,
NSAID, menthol
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
C
51
Nociceptive,
peripheral,
neurogenic
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
C
52
Skin irritation
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
C
53
Amitriptyline,
nortriptyline
(Tramadol has
SNRI effects)
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
D
54
Peripheral or
central
neurogenic,
some
nociceptive
pain
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
D
55
Hypertension,
Orthostatic
Hypotension,
arrhythmias, falls
in the elderly, dry
mouth,
constipation,
blurry vision,
sedation,
insomnia, risk of
serotonin
syndrome
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
D
56
Gabapentin, duloxetine,
pregabalin, topiramate
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
E
57
Peripheral or
Central
neurogenic
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
E
58
Dizziness,
fatigue, ataxia,
peripheral edema,
dry mouth, weight
gain or loss, liver
damage
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
E
59
For spasticity:
baclofen, dantrolene, &
tizanidine
For MSK conditions:
carisoprodol,
chlorzoxazone,
cyclobenzaprine, metaxalone,
methocarbamol,
& orphenadrine
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
F
60
Muscle spasm or
trigger points: FMS, MPS
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
F
61
Dizziness, drowsiness,
fatigue, weakness
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
F
62
Tramadol
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
G
63
Peripheral or
central neurogenic
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
G
64
Nausea, constipation,
sedation, dizziness, vomiting, pruritus, sexual dysfunction,
sleep disturbance, hyperalgesia, tolerance,
addiction, risk of
serotonin
syndrome
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
G
65
Codeine, hydrocodone,
morphine, oxycodone, methadone, fentanyl patch
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
H
66
Peripheral or central neurogenic, cancer pain
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
H
67
Nausea, constipation,
sedation, dizziness, vomiting, pruritus, sexual dysfunction, sleep disturbance & hyperalgesia, tolerance,
addiction, risk of serotonin syndrome
a. Para-aminophen
ols
b. NSAIDs
c. Topical
d. Adjuvant antidepressants (Tricyclics,
SNRIs)
e. Adjuvant anticonvulsants
f. Muscle relaxant
g. Weak opiate
h. Strong opiate
H
68
Modified T/F:
We must assess both the illness & the Pt.'s relationship with
the illness. We must understand the patient as a person & shared decision-making in their care
T T
69
Modified T/F:
Effective clinicians develop strategies to identify & deal
with difficult behavior to enhance patient adherence & reduce the chance of frustration & burnout. Abuse survivors & their traumas do not have difficulty distinguishing between physical & emotional pain
T F
have difficulty
70
What are the 6 sx that SA pts may present with?
Hypervigilance
Anxiety
Disempowerment & Distrust
Somatization
Transference
Dissociative reactions
71
Modified T/F:
Clinicians treating chronic pain may have empathy fatigue. As healthcare professionals we get tired from dealing with pts so we also need to rest.
T T
72
Modified T/F:
A thorough subjective interview helps develop a PT diagnosis by understanding of the
patient' s narrative. This is done by building rapport and indicating description of pain, Non-pain signs & Sx including motor, sensory, &
autonomic changes, and addressing psychosocial issues such as abuse history, anxiety, depression, drug use, PTSD, etc.
T T
73
What are the 4 things done in systems review?
Vital signs
Integumentary system
Musculoskeletal screening
Neuromuscular testing
74
What should you check for in palpation?
Check for tenderness, muscle spasm, trigger points, or
hyperalgesia & allodynia
75
Identify: Measures the amount of pressure to turn touch into
pain or comfortable pressure into pain
Algometer
76
Identify: Point at which comfortable pressure turns to slightly
unpleasant pain
Pressure pain threshold
77
Modified T/F:
Increased PPT at remote sites is indicative of
hyperalgesia. Activity & Participation would include activities limited by chronic pain include walking, mobility, changing or maintaining body position, toileting,
preparing meals, & doing housework.
F T
decreased
78
Modified T/F:
Chronic pain leads to participation restrictions such as impaired
family relationships, inability to engage in employment, &
compromised intimate relationships. Decreased PPT at remote sites is indicative of
hyperalgesia.
T T
79
Give 6 OMTs for Activity & Participation
1. Revised Fibromyalgia Impact Questionnaire (FIQR)
2. Oswestry Low Back Pain Disability Questionnaire
3. Patient-Specific Functional Scale
4. 30 Second STS test
5. Timed Up & Go
6. 10 Meter Walk Test
80
GIve 9 Professions part of the Multidisciplinary Pain Management Team
Primary care physician
Pain specialist
Physiatrist - Rehab MD
Anesthesiologist - for prescription of pain
medications
Psychologist/ Psychiatrist
Pharmacist - to dispense pain medications
Social worker - for pts who suffered abuse
Physical therapist
Sleep therapist
81
Injection of anesthetic with or without steroids
into facets or
sacroiliac (SI) joint
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
A
82
Facet or SI pain
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
A
83
Botulinum toxin A
(botox) injections
into trigger points
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
B
84
Myofascial pain
syndrome, which
may be associated
with various other
pain syndromes
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
B
85
Injection of anesthetic with or without steroids
into peripheral nerve, celiac plexus, paravertebral
sympathectomy,
medial branch
block, stellate
ganglion block, cervical paravertebral
sympathectomy
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
C
86
Low back pain (LBP) Complex regional pain syndrome (CRPS)
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
C
87
Steroid injections with or without local anesthetics; opioid injections into intrathecal space
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
D
88
Neck pain, LBP,
radiculopathy,
postherpetic
neuralgia (PHN)
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
D
89
Chemical denervation,
cryoneurolysis,
cryoablation,
thermal intradiscal procedures,
radiofrequency
ablation
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
E
90
Neuropathic, facet,
or musculoskeletal
pain
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
E
91
Subcutaneous peripheral nerve stimulation & spinal cord stimulation
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
F
92
Peripheral nerve injuries, neuropathic pain, CRPS, failed low
back surgery, phantom limb pain, cauda equina
injury, radiculopathy,
peripheral vascular disease, visceral pain, multiple sclerosis
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
F
93
Infusion of medication into spinal cord or specific arteries serving involved structures
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
G
94
Cancer, refractory spasticity due to cerebral or spinal cord injury, intractable pain with objective pathology
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
G
95
Vertebroplasty, kyphoplasty, percutaneous disc
decompression,
nucleoplast
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
H
96
Osteoporotic
compression
fracture,
radiculopathy
A. Joint block
B. Trigger point injection
C. Nerve block
D. Epidural, intrathecal injections
E. Ablative techniques
F. Implanted electrical
stimulator
G. Implantable drug
delivery
H. Minimally invasive
spinal procedure
H
97
Give 5 general principles of Chronic Pain Management (14 total)
Improve ability to cope with pain
● Teach nonpharmacological pain management techniques
● Increase physical strength, endurance, & cardiovascular
fitness
● Increase mobility, independence, & functional activity
● Improve sleep
● Teach proper body mechanics
● Increase social & recreational activities
● Improve mood & cognitive function
● Decrease or eliminate dependence on medications
● Decrease overutilization of the healthcare system
● Improve psychological & emotional well-being
● Enhance vocational potential
● Provide vocational rehabilitation for paid work, volunteer
work, & hobbies
● Enhance family communication & function
98
Give 5 Goals of EDUCATIONAL COMPONENTS OF
CHRONIC PAIN MANAGEMENT (12 total)
Acknowledge that chronic pain is real
● Recognize the complex, biopsychosocial nature of pain, &
need for multifaceted management program in which the
patient is an active participant
● Understand the impact of pain on sleep, mood, energy,
fitness, ability to work, family life, & stress
● Avoid letting pain guide activity or medication use
because pain-based treatment encourages pain behavior
Recognize & utilize wellness-behaviors
● Recognize the role of poor posture & body mechanics in
perpetuating pain
● Overcome fear of movement through gradual exposure to
feared activities
● Learn relaxation strategies
● Actively participate in own management program
● Enlist family support & participation in management
program
● Participate in an exercise program, either through
physical therapy, independently, or using community
resources
● Minimize fear of movement & activity reduction due to
fear of movement
99
Modified T/F:
Functional goals & graded activities should emphasize pain-based goals. Pts need reassurance to do leisure & recreational activities
F T
Functional goals & graded activities that emphasize wellness behavior rather than pain-based goals
100
Give 5 PT MANAGEMENT for Chronic Pain (12)
Relaxation techniques
Physiological quieting & self-regulation
Cognitive Behavioral Therapy
Self-care strategies
Family & caregiver education
Personal intimacy
Therapeutic Exercise
Manual Therapy
Neuromuscular Reeducation
Assistive Devices
Physical & Electrotherapeutic Modalities
Alternative approaches
101
Identify: Beliefs, attitudes, & behaviors are modified to alter
the experience of pain, overcome fear-avoidance,
improve function, & minimize disability
CBT
102
Give 7 Examples of Physiological quieting & self-regulation
Education & reassurance
○ Strategies to improve & monitor muscle function
○ Proprioceptive awareness training
Postural relaxation training
○ Diaphragmatic breathing
Methods of improving sleep onset
○ Instructions on physical activity, diet, & fluid intake
103
Enumerate CBT in scope of PT practice (5)
Education about relaxation strategies
○ Graded activity
○ Pacing
○ Identification of counterproductive thought patterns
○ Functional restoration
104
Give 7 examples of Self-care strategies
Home administration of heat, cold, massage, topical
rubs, TENS, traction units, tennis ball release
105
What are the 5 Therapeutic Exercises that can be used
Graded exercise
Postural exercises
Aerobic conditioning
Functional exercises
Balance Exercises
106
What are the 3 Manual Therapies that can be used
Manipulation
Muscle energy techniques
Massage/Trigger point therapy
107
Give 4 Examples of Neuromuscular Reeducation
EMG Biofeedback
Yoga, Qigong, Tai Chi
108
Give 4 Examples of Assistive Devices that can be used
Shoe orthotics
○ Knee bracing
○ Adaptive devices
Assistive device
109
Give 5 Examples of Physical & Electrotherapeutic Modalities that can be used
HMP, US, Laser, Traction, TENS (Gate Control Mechanism)
110
Give 4 examples of Alternative approaches that can be used
Mental therapy (hypnosis & meditation)
Magnets
○ Herbal medicines
○ Supplements
111
The insula contributes to affect, cognition, and response
selection.
a. True
b. False
False
112
Allodynia is an increased response to a stimulus that is
normally painful
a. True
b. False
False
113
Chronic pain affects men more than women.
a. True
b. False
False
114
Chronic pain can be considered a disease in itself
a. True
b. False
True
115
Suffering is the emotional aspect of chronic pain
a. True
b. False
True
116
Identify: It is a complex network of synaptic links initially determined by genetics.
Pain Neuromatrix
117
Peripheral sensitization is mediated by cytokines,
prostaglandins, and serotonin.
a. True
b. False
True
118
Central sensitization provides a physiologic explanation
for pain in the absence of identifiable injury.
a. True
b. False
True
119
Examples of blue flags are fear, anxiety,
catastrophization, and distress.
a. True
b. False
False
120
Chronic pain may or may not be associated with an
underlying pathology.
a. True
b. False
True
