Pain Neuroscience

t/f it is possible to have pain and not know about it

false

t/f when part of your body is injured, special pain receptors convey the message to your brain.

false

t/f pain only occurs when you are injured or at risk of being injured

false

t/f special nerves in your spinal cord convey danger messages to your brain

true

t/f when you are injured, special receptors convey the danger message to your spinal cord

true

t/f nerves adapt by increasing their resting level of excitement

true

t/f chronic pain means an injury hasnt healed properly

false

t/f the body tells the brain when it is pain

false

t/f nerves adapt by making ion channels stay open longer

true

t/f descending neurons are always inhibitory

false

t/f pain occurs whenever you are injured

false

t/f when you injure yourself, the environment that you are in will not affect the amount of pain you experience, as long as the injury is exactly the same

false

t/f the brain decides when you will experience pain

true

what are the descriptors for nociceptive pain?

• pain reproduced with movement

• localized pain

• clear MOI or pattern

• predictable healing time

what are the descriptors for neurogenic pain?

• neuro descriptors like numb, tingling, shooting, etc

• follows peripheral or nerve root pattern

• could be BL

• pain in neurodynamic position like SLR

• MOI that compresses or injures a nerve

what are the descriptors for nociplastic pain?

• no pattern

• no clear mechanism

• stress and other factors

• lots of different answers of what could be wrong and failed treatments

what are yellow flags with nociplastic pain?

failed treatments, family, fear, job concerns, different explanations

what are phrases we should not use in order to do no harm?

• degenerated

• torn

• worn out

• damaged

• bone on bone

• its all in your head

discuss the living alarm system metaphor

• used for nociceptive or nociplastic pain

• helps the patient understand why anything can make them hurt

discuss the CEO metaphor

• used for nociceptive or nociplastic pain

• describes communication between the CNS and PNS as well as upregulation or loss of inhibition resulting in increased pain intensity

discuss the brain in a pain meeting metaphor

• used for nociplastic pain

• helps the patient understand why they may be feeling overly emoitional along with pain

discuss the lion in the room metaphor

• explains the multifaced neuroendocrine response to pain

• used for nociceptive or neurogenic pain

explain the nerves as sensors metaphor

• explains the role of nerves in detecting stimul and why the pat may experienc pain in response to nonpainful stimuli

• used for nociplastic or neurogenic pain

discuss the nosy neighbors metaphor

• used for nociplastic pain

• explains sprouting and its consequences including a smudgy humunculus and diffuse pain

discuss the 3 things nerves like metaphor.

used for neurogenic pain

when would you use the brief pain inventory?

• in adults and elderly adults with arthritis, cancer, chronic pain, mixed conditions, and pulmonary diseases

• pain mechanism: nociceptive, neurogenic

when would you use the magill short form pain questionnaire

• population: adults with chronic pain including rheumatic conditions, acute low back pain, cancer disorder, individuals with arthritis or joint pain conditions

• pain mechanism: nociplastic

when would you use the pain detect questionnaire

• population: chronic low back pain, chronic musculoskeletal pain, OA, and RA

• pain mechanism: neuropathic or nociceptive pain

when would you use the STarT back screening tool?

• population: patients with chronic low back pain

  • pain mechanism: nociplastic

when would you use fear avoidance belief questionnaire

• population: 18-64, 65%, chronic pain, mixed conditions, MSK conditions, and spinal cord injuries

• pain mechanism: nociceptive, neurogenic, neuroplastic

when would you use the tampa scale of kinesiophobia?

• population: patients with chronic MSK pain, specifically back/lower extremity/cardiac/tempormandicular/fibromyalgia

• pain mechanism: nociplastic

when would you use the pain catastrophizing scale

• population: adults with or without chronic pain, arthritis, mixed conditions

• pain mechanism: nociplastic

when would you use the LANSS?

• population: used in any patient presenting with chronic pain or neuropathy symptoms

• pain mechanism: neurogenic

when would you use the global rating of pain scale?

population: general population of patients experiencing pain

mechanism: any pain mechanism

when would you use the central sensitization inventory?

• population: chronic pain, CNS issues like fibromyalgia

• pain mechanism: nociplastic