Client Management Case Study

The perception of pain and the emotions that control intensity differ in individuals. Since feeling pain is somewhat adaptive, when one experiences it, he or she becomes aware of an injury and tries to remove oneself from the source that caused the injury. For this reason, pain is considered neuropathic or inflammatory in nature. Thus, when pain is the outcome from the damage caused to the neurons of the peripheral and central nervous system, then that pain is neuropathic. However, if the pain signals any kind of tissue damage, then the pain is inflammatory in nature. Due to various types of pain, the interpretation of pain by neurons and the source of that pain

Pain effects the body through the nerves. The phenomena of pain is conveyed from a peripheral part of the person, through afferent nerves to a part of the brain, similar to sight, touch, and hearing. These signals are then interpreted by the brain as pain (Murphy, 1981). The nerve cells used to relay pain messages to the brain are specific nerve cells called nociceptors. These nerves do not send messages until "the stimulus reaches noxious levels," (McClesky, 1992).

There are two classifications of pain, namely, somatic pain and visceral pain. Somatic pain results from injury from the skin and mucosa, muscle bone tendons, ligaments, joints and

Kimberly did a great job pulling back/controlling call when realizing her the client was running into each other.

The first stage of nociception is transduction, this is the perception of a noxious (damaging) stimulus, which activates high threshold nociceptors through multiple mechanisms, such as, thermal (heat), mechanical (ligaments being stretched) and chemical. With chemical activation, infection creates inflammation around the wound to promote healing, some chemicals produced trigger nociceptors (sometimes constantly) and some lower threshold of activation for other nociceptors (Basbaument et al 2009) meaning a person can often feel more pain. The second stage of nociception is transmission; this is where the information detected is sent to brain by specialised nerve pathways. Aδ fibres are fast and specific, due to them being myelinated and unimodal (they respond to a specific type of pain per fibre) and C fibres conduct slow sensation as they are unmyelinated and polymodal (responding to multiple types of pain per fibre). The final stage of nociception is interpretation, this is where the brain processes painful stimuli and decides if it should be acted on (if there is a danger). It is only at this point that pain can be felt. Nociceptors do not send a pain signal but instead alert the brain to

Currently, it has bee classified the pain based on the underlying neurophysiological mechanisms responsible for its generation and/or maintenance. The mechanisms based classification for pain is essential for physiotherapists to better understand of clinical presentation of pain and can improve the clinical outcomes by directing treatment into the dominant neurophysiological mechanisms underlying the pain (Smart et al, 2008).

The initial post tackles a fundamental idea as to the role of imaging in the diagnosis of low back pain (LBP). As McKinnis (2014) reiterated the fact that “no imaging can be prudent” in cases of suspected disk herniation in the first six weeks preceding the advent of the symptoms (p. 344). The discussion clearly points out the significance of the clinical practice guidelines of the American College of Physicians and the American Pain Society. The collaboration between health care professionals is necessary to conserve costs while sustaining a high quality of care for the patients.

P: Client has decrease avoidant reactions (i.e. hiding and isolating) from 6x a day to 2x a day.

Range of motion is also noted to be decreased for all the involved body parts: cervical spine, lumbar spine, bilateral wrist, bilateral knees, and bilateral ankles. The patient has circumscribed trigger point6s with twice response and referred pain; positive taut bands with jump signes are noted in bilateral paracervical musculatures. Spurling’s and cervical distraction tests are bilaterally positive during cervical spine examination. For the lumbar spine, the patient is positive for straight leg raise bilaterally and Braggard’s test. Lumbar spine straight leg raise test cause low back pain with radiation to both posterior thigh upon 45 degrees of leg raising. Codman’s test, impingement, Yeargason’s test on the left side of the shoulder are noted to be positive. The patient is also positive for Tinel’s sign and Phalen’s sign bilaterally. Upon examination of the knee, patellar tracking is noted to be painful bilaterally. The patient also is bilaterally positive for Apley’s compression, distraction, and McMurray’s test. The patient is also positive for valgus and varus stress test

Nociceptive pain is the pain experienced when the body is damaged by temperature, chemical, or mechanical means. When damage is caused, afferent neurons respond and the four phases of nociception result. Transduction occurs when the free ends of silent nociceptors convert toxic experience into an electrical current, leading to a nerve impulse. The nerve impulse is then transmitted to the dorsal root ganglion in the spinal cord, then the dorsal

Here we have gone over two different ways pain can be experienced. It can be experienced through physical and emotional standpoints. The contact of a football player with the bleachers shows how pain can be experienced physically, and a couple that has broken up, experiences heartbreak, which is another form of emotional pain. Pain shows the mistakes one has made in the past and allows the individual to learn from them, making them realize that they should not do what they did again to experience that pain in the first

Walker and Avant (2011) state that attributes appear in the literature when describing the concept and are used to differentiate the concept from other concepts. After comprehensive review of the literature the defining attributes of the concept of pain are as follows:

Acute pain arises when painful stimuli are detected by Patient –F’s nociceptors (Julies and Basbaum,2001). Nociceptors are highly-threshold sensory receptors (Sinatra, 2002) of the peripheral somatosensory nervous system (Sorkin and Yaksh,2013) that transduce noxious stimuli (D’Mello and Dickson,2008). Patient-F’s nociceptors were stimulated mechanically by the surgical incision and cutting of the femoral bones (ohara et, al,2005).

Pain is something that connects all of us. From birth to death we can identify with each other the idea and arguably the perception of it. We all know we experience it, but what is more important is how we all perceive it. It is known that there are people out there with a ‘high’ pain tolerance and there are also ones out there with a ‘low’ pain tolerance, but what is different between them? We also know that pain is an objective response to certain stimuli, there are neurons that sense and feel pain and there are nerve impulses that send these “painful” messages to the brain. What we don’t know is where the pain

There are many different types of pain which can be categorised depending on how the pain is caused and how long the pain lasts. If pain results from tissue damage then it is called nociceptive pain and this includes pain from pressure applied outside of the body, like a cut or a burn, or from pressure inside the body such as a tumour. Another type of pain is neuropathic pain which is pain experienced when there is damage to