Pain/PAMs

Acute pain approaches

PAMs, prevention

Chronic pain approaches

Education/training = body mechanics, conditioning, task mod.

PAMs may be helpful

Pain Prevention

Body mechanics, positioning, energy conservation, AE, physical activity

Pain intervention > Mind-Body

Address pain from a psychophysiological approach

Relax or Rethink

Relax Approach

Breathing, biofeedback, guided imagery, PMR

Rethink approach

Mindfulness, CBT, self-talk, mirror therapy

PAMs are…

preparatory activities

Allodynia

Painful stimulus from things that shouldn’t be painful

Hyperalgesia

increased pain

Mild pain meds

aspirin, acetaminophen, ibuprofen

Moderate pain meds

codeine

Severe pain meds

morphine

Cryotherapy effects

constrict circulation, numb pain

Heat effects

increase circulation, relax muscles

E-stim effects

contracts muscles, sensory stim

Ice massage

for targeted/smaller areas

Cold packs

for larger areas; use insulating materials. About 15 min

Whirlpool

For digits/hand; move hand during treatment

Cold compression

For reducing edema

Avoid heat if….

Edema

Hot packs

for larger areas; use A LOT of insulation

Paraffin

For pain and ROM

Fluidotherapy

desensitization, pain, ROM, incr. blood flow, wounds, swelling, acute injuries

Contrast Bath

Creates a pumping action between vasoconstriction and vasodilation

decrease edema

Ultrasound

For deep structures

Continuous wave = deep heat (ROM)

Pulsed = promotes healing

When NOT to use ESTIM

near pacemakers/metal, diminished sensation, pregnancy, wound, fragile skin, cancer

NMES and FES

to evoke muscle contraction for motor control, strength and ROM

TENS

For pain control; best for acute pain and trigger points

NO muscle contraction

Iontophoresis

for topical medication