A Mechanism-Based Approach to Physical Therapist Management of Pain.
A Mechanism-Based Approach to Physical Therapist Management of Pain.
Phys Ther. 2018 May 01;98(5):302-314
Authors: Chimenti RL, Frey-Law LA, Sluka KA
Abstract
Pain reduction is a primary goal of physical therapy for patients who present with acute or persistent pain conditions. The purpose of this review is to describe a mechanism-based approach to physical therapy pain management. It is increasingly clear that patients need to be evaluated for changes in peripheral tissues and nociceptors, neuropathic pain signs and symptoms, reduced central inhibition and enhanced central excitability, psychosocial factors, and alterations of the movement system. In this Perspective, 5 categories of pain mechanisms (nociceptive, central, neuropathic, psychosocial, and movement system) are defined, and principles on how to evaluate signs and symptoms for each mechanism are provided. In addition, the underlying mechanisms targeted by common physical therapist treatments and how they affect each of the 5 categories are described. Several different mechanisms can simultaneously contribute to a patient's pain; alternatively, 1 or 2 primary mechanisms may cause a patient's pain. Further, within a single pain mechanism, there are likely many possible subgroups. For example, reduced central inhibition does not necessarily correlate with enhanced central excitability. To individualize care, common physical therapist interventions, such as education, exercis...
Source: Physical Therapy - Category: Physiotherapy Authors: Chimenti RL, Frey-Law LA, Sluka KA Tags: Phys Ther Source Type: research
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