Pain in Older Adulthood (OT 504 Week 9 Small Group)

What are the six major types of pain?

Nociceptive, Neuropathic, Referred, Chronic, Acute, Inflammatory.

What is nociceptive pain?

Pain resulting from tissue damage or injury that activates nociceptors.

What are the two types of nociceptive pain?

Somatic (sharp, aching, throbbing pain) and Visceral (deep, vague, squeezing pain).

Common diagnoses associated with nociceptive pain?

Repetitive use injuries, Back pain, Knee pain, Shoulder pain, Hip pain, Wrist pain, Osteoporosis.

OT interventions for nociceptive pain?

Assistive devices, Adaptive equipment, Body mechanics, Compensatory techniques, Physical Agent Modalities (PAMs), Balance rest with light movement, Patient education about healing, Splinting/bracing, Immobilization when appropriate, Self-management education.

Why is movement encouraged during healing from nociceptive pain?

Light movement improves circulation and reduces focus on pain while balancing appropriate rest.

What is neuropathic pain?

Chronic pain caused by damage or dysfunction of the peripheral or central nervous system.

How is neuropathic pain commonly described?

Burning, Tingling, Shooting pain, Pins and needles.

Causes of neuropathic pain?

Peripheral neuropathy, CNS damage, Nerve compression, Phantom limb pain.

Common diagnoses associated with neuropathic pain?

Diabetic neuropathy, Postherpetic neuralgia, Trigeminal neuralgia.

OT interventions for neuropathic pain?

Flare management, Interdisciplinary care, Self-management, Activity pacing, Energy conservation, Assistive devices, Adaptive equipment.

What OT interventions did the professor emphasize for phantom limb pain?

Mirror therapy, CBT, Interdisciplinary care.

What is referred pain?

Pain felt in a location different from where it originates because the nervous system misinterprets pain signals.

Examples of referred pain?

Heart attack → left arm/chest, Dental problems → headache, Gallbladder → shoulder, Liver → neck.

OT interventions for referred pain?

Patient education, Emergency response if accompanied by physiological symptoms.

What is chronic pain?

Pain lasting beyond expected healing time.

Causes of chronic pain?

Injury, Nerve damage, Cancer, Musculoskeletal disorders, Psychological factors.

Common diagnoses involving chronic pain?

Chronic nociceptive pain, Fibromyalgia, Cancer pain, Peripheral vascular disease.

OT interventions for chronic pain?

Lifestyle Redesign®, Low-impact movement, Stretching, Relaxation, Mindfulness, Acupuncture/massage (adjunctive), Self-management, Energy conservation, Interdisciplinary care.

What important clinical reminder did the professor emphasize about chronic pain?

Believe patients when they report pain and meet them where they are.

What is acute pain?

Pain from injury, trauma, surgery, or illness that follows a predictable healing process.

Common diagnoses involving acute pain?

Total hip arthroplasty, Total knee arthroplasty, Spinal surgery, Falls, Fractures.

OT interventions for acute pain?

Post-op education, Healing timelines, Adaptive equipment, Symptom self-management, Energy conservation.

What is inflammatory pain?

Pain caused by inflammation that may be acute or chronic.

Conditions associated with inflammatory pain?

Arthritis, Autoimmune disease, Infection, Tissue injury.

Common diagnoses involving inflammatory pain?

Osteoarthritis, Rheumatoid arthritis, IBS, Crohn's disease, Ulcerative colitis.

OT interventions for inflammatory pain?

Flare management, Lifestyle Redesign®, Adaptive equipment, Assistive devices, Energy conservation, Low-impact exercise, Stretching.

What is the Brief Pain Inventory (BPI)?

Measures pain severity and pain interference through a questionnaire, especially useful for chronic pain.

What is the Numeric Rating Scale (NRS)?

0–10 scale assessing current pain, best pain in the last 24 hours, worst pain in the last 24 hours.

What important point did the professor emphasize about pain ratings?

Everyone experiences pain differently—believe patients and don't judge pain by appearance.

What is the Verbal Pain Intensity Scale?

Describes pain as No pain, Mild, Moderate, Severe, Worst possible pain.

What is the Wong-Baker Faces Scale?

Quantifies pain and is useful for individuals with communication, cognitive, or visual challenges.

What is the OUCH-CPQ?

Occupational Understanding of Challenges Chronic Pain Questionnaire that measures pain location, description, occupations, and goals for occupational therapists.

Approximately how long does the OUCH-CPQ take?

About 60 minutes.

What is the Chronic Pain Acceptance Questionnaire (CPAQ)?

Measures activity engagement and pain willingness; higher score equals greater pain acceptance.

What is the PAINAD?

Pain Assessment in Advanced Dementia, used for older adults with dementia and cognitive impairment and limited verbal communication.

What OT model was discussed for pain intervention?

Person-Environment-Occupation-Performance (PEOP) Model.

ADL/IADL interventions for pain?

ROM, Strengthening, Adaptive equipment, Joint protection, Ergonomics, Body mechanics, Activity pacing, Energy conservation, Mobility training, Positioning, Neuromuscular re-education, Nerve mobilization.

Self-management interventions?

Pain communication, Medication management, Sensory strategies, Coping strategies, Time management, Activity pacing, Energy conservation, Eating routines, Physical activity routines.

What are four common energy management strategies?

Spoon Theory, Boom-Bust Cycle, Energy Budget, Water Pitcher.

What is a flare-up?

A temporary increase in pain or symptoms (spasm, stiffness, fatigue) lasting hours to days.

Common flare-up triggers?

Overdoing activities, Stress, Poor sleep.

Lifestyle interventions for persistent pain?

Anti-inflammatory diet, Hydration, Medication adherence, Sleep hygiene, Ergonomics, Body mechanics, Physical activity, Establishing baseline over 3 days/3 repetitions.

Psychological interventions for chronic pain?

CBT, ACT, Relaxation, Mindfulness, Progressive muscle relaxation, Biofeedback, Diaphragmatic breathing, Guided meditation, Assertiveness training, Motivational Interviewing.

Examples of adaptive equipment for pain management?

Ergonomic utensils, Grab bars, Dressing aids, Reachers, Walkers, Canes, Shower chairs.

What are the five steps to connect assessment to intervention?

Determine occupational performance abilities, Identify problem areas, Determine WHAT the problem is and WHY it is occurring, Develop measurable goals, Make recommendations/referrals.

What determines the most appropriate OT intervention?

Understanding WHY the problem is occurring—not just WHAT the problem is.

What should every OT goal include?

Timely, Measurable, Reimbursable, Occupation-centered, Client-centered.