Pain
What is Radiating Pain?
-Pain felt in an area of the body that is NOT injured -Sharp, shooting, burning, intense pain in specific pattern -USUALLY accompanied by numbness & tingling -pain follows a specific nerve root distribution (Sciatica, burner/stinger)
What is Central Biasing Mechanism?
-Powerful pain inhibition system -works through stimulation and release of chemical mediators in the brain -Descending System (starts in the brain then pain stops) -Noxious input causes pain -brain releases mediators to block pain (ONLY released while in pain) -stays blocked until/if the patient re-injures themselves
What is the Gate Theory?
-Proposed by Melzack & Wall (1965) -the ONLY Ascending System (away from CNS, message is sent to the brain and stops pain) -we can make this happen -Noxious input causes pain, opening gate -non-noxious input closes gate, blocking pain sensation -temporary pain relief (SHORT TERM) (Hitting your funny bone)
Functions of Pain
-Protect the body against further injury (warning sign) -Guide functional recovery (Rehab&Return to Activity) -Enhances disability (Chronic Pain)
What is Endorphin Release?
-endorphin's are produced in the pituitary gland and can be released throughout the body. -Anterior pituitary glad stimulated by Reticular formation in the brain (limbic system-controlled by emotions) -controlled by emotions -"Fight or Flight" (adrenaline)
What is Acute Pain?
-has a recent, sudden onset (KNOWN MECHANISM) -hurts all the time (during activity and not) -results in loss of function -associated with tissue damage -subsides with tissue healing
What is Referred Pain?
-is pain felt in an area of the body that is NOT injured -deep, dull, achy, non-specific pain -Pain does NOT follow a nerve root distribution -dependent on where brain interprets the painful stimulus -no reproduction on symptoms when the painful area is tested -testing of proximal or distal area reproduces pain -difficult for the patient to pinpoint where it hurts *IF YOU CAN'T REPRODUCE IT, DON'T TREAT IT
What is Chronic Pain?
-occurs AFTER healing has occurred (extended BEYOND normal tissue healing) -results in loss of function -pain decreases overtime & usually hurts ONLY when stressed -slow onset, long duration -may result in depression and/or addiction -does not indicate tissue damage -mechanism UNKNOWN
What are the 3 Pain Modulation types?
1. Gate Theory 2. Central Biasing Mechanism 3. Endorphin Release
What is Pain?
An unpleasant sensation with emotional aspects associated with ACTUAL or POTENTIAL tissue damage.
Potential Tissue Damage
Beginning stages before an actual injury that indicate a future injury if nothing changes.
(Referred vs Radiating) Right upper extremity pain secondary to a cervical spine disc herniation.
Radiating Pain (The disc herniation is nerves)
(Referred vs Radiating) Left hand pain secondary to compression on the ulnar nerve.
Radiating Pain (Ulnar Nerve)
(Referred vs Radiating) Deltoid tuberosity pain secondary to sub-acromial bursitis.
Referred Pain
(Referred vs Radiating) Left Shoulder pain secondary to a ruptured spleen.
Referred Pain
What is the ideal athlete? (Tolerance vs Threshold) Why?
We want an athlete with a LOW Pain THRESHOLD and a HIGH Pain TOLERANCE -With a low pain threshold, we can catch injury quicker. -With a high pain tolerance, the athlete can rehab and get back to normal faster.
Is Pain Beneficial? If so, why?
YES, because: -it allows the clinician to know when something is wrong. -lets us know if rehab is working (Pain will decrease). -Lets clinician know if the patient's workload is too much.
What is Pain Tolerance?
the maximum level at which pain can no longer be ignored and the patient can no longer withstand the pain.
What is Pain Threshold?
the minimum stimulus that first causes pain; the first feelings of pain.