Pain Perception

Pain

- defined as the most reason why people visit a healthcare provider as well as the PT

- unpleasant sensory and emotional experiences associated with actual or potential tissue damage

- can affect emotions

Acute Pain

usually fast and can last for a few days.

Chronic Pain

- pain felt lasted for weeks, months, years

- severe pain

Biopsychosocial Model

- correlate tissue damage to pain sensation

- recognizes the physical, interactive, personal, and environmental factors that can affect body functions, structures, activity, and participation in the life activities of your pt

ICF Model

PT visualizes the entire scenario of the pt, because of his/her condition and enables the PT to think what he/she can do to improve and help the pt to get back to their previous state.

Causalgia

a syndrome of sustained burning pain, allodynia, and hyperpathia after a traumatic nerve lesion, often combined with vasomotor and sudomotor dysfunction and later trophic change

Dysesthesia

an unpleasant abnormal sensation, whether spontaneous or evoked

Hyperpathia

a painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold.

Paresthesia

an abnormal senstion, whether spontaneous or evoked.

Suffering

- refers to the affective component of pain

- includes both emotional and cognitive components, and may be due to a combination of unpleasantness and catastrophizing

- usually caused by emotional damage

Psychogenic

an older term for pain believed to be caused by psychological factors when organic factors were absent or not severe enough to explain the pain complaint.

• Severe unremitting pain

• Pain unaffected by medication or position

• Severe night pain

• Severe pain with no history of injury

• Severe spasm

red flags in pain.

Spasm

is a normal response of our body, it is a protected contraction of muscle to limit motion.

Musculoskeletal Pain

- pain is lessened at night because structures are rested

- pain is also superficial or sharp

- pain decreases with cessation of activity

- pain can be either or intermittent and is aggravated by mechanical stress

Systemic

- other organs or structures involved other than the root cause of the pain

- deep aching and throbbing

- constant type of pain; spasm is constant

- not aggravated by mechanical stress as compared to the msk system

- associated with the following:

• Jaundice

• Migratory arthralgias

• Skin rashes

• Easy fatigability

• Sudden weight loss

• Low grade fever

• Generalized weakness

• Slightly progressive symptoms

• Tumors

Jaundice

yellowish discoloration.

Temporal Pattern

duration and chronicity.

Muscle

aching, dull, and cramping.

Ligament

dull and aching.

Nerve Root

sharp, shooting, radiating, and lightning-like.

Bone

deep, nagging, and dull.

Fracture

sharp, deep, and excruciating.

Vasculature

throbbing and diffuse.

• Degree of physical damage

• Personality of the patient

• Social context

• Cultural context

• Attitude and behavior of health professional

• Past experience

• State of mind

factors that influence pain.

Verbal Report Scale

- adjectives are used to describe different levels of pain

- purely verbal

- “from 0 to 10, gaano kasakit yung pain na nararamdaman?”

Visual Analog Scale

allows the patient to visually gauge the amount of pain along a solid 10-cm line.

Numerical Rating Scale

the patient rates the pain from 0 (no pain) to 10 (worst pain).

Body Diagram

- ipapa-plot mo kay pt. kung saang part ng katawan masakit

- lagyan ng “X” sa (R) shoulder para ma-visualize ‘yong location ng pain

Faces Pain Rating Scale

- use of emoji

- hospitals usually have these

Temperature Rating Scale

- “ituturo ni pt kung anong level of pain”

Outcome Measure Tool

- assessing the pain and sensory of the pt

- to determine whether the pain is due to neuropathic in nature or not

LANSS Pain Rating Scale

- Leeds Assessment of Neuropathic Symptoms and Signs

- 2 areas

● Pain Questionnaire

● Sensory Testing

- Total score is 24,

• < 12 = the cause is not neuropathic in nature

• 12 = the cause is neuropathic in nature

• Physiological

• Sensory

• Affective

• Cognitive

• Behavioral

• Cultural

common causes that can contribute to the paint.

Therapeutic Exercises

- to address the pain

- e.g. peripheral joint mobilization

• using a grade 1 or 2 dose for pain relief

• grade 3 and 4 for stretching maneuvers

Manual Therapy

include manipulation techniques.

Neuromuscular Reeducation

- NMES

- electrical stimulation

Assistive Device

to unload the pt’s weight.

Physical and Electrotherapeutic Modalities

- TENS

- Ultrasound

- Hot and cold compress

- IRR