PT Examination "PAIN"

Question 1

Make a subjective assessment of pain

Answer 1

• Severity
• Irritability
• Nature
• Stage

Question 2

Severity

Answer 2

• How bad is it?
• What are you not able to do that you used to do?
• 1-10 pain scale

Question 3

Irritabilit

Answer 3

• How easily are your symptoms provoked?

- How much do you have to do to bring on your symptoms?

Question 4

Nature

Answer 4

• Where or how does it originate?
• Was it from an event?
• What structures are involved?

Question 5

Stage

Answer 5

• Time frame, acute, chronic, subacute?

- Is it getting better, worse or staying the same?

Question 6

Is the pain able to be classified

Answer 6

• Intrarticular
• Periarticular
• Neural Related
• Discogenic
• Muscular Problem

Question 7

Intrarticular

Answer 7

• Inner capsule, compression, synovial fluid
• More constant at end range, more debilitating over all, painless resting periods do not exist, disorder is chronic, pain is deep seated, pain will return soon after treatment, pt on lots of medication, pain occurs in multiple directions with varying symptoms

Question 8

Periarticular

Answer 8

• OA, RA, Bursitis
• Painful during stretching or squeezing, end range of motion pain or impingement, not typically chronic, painless positions are easily found, can involve he outer layer of he synovial lining, if not contractile (ligament), if contractile (tendon)

Question 9

Neural

Answer 9

• Bizarre or weird symptoms, difficulty describing the symptoms, whole hand or whole leg involvement, may be highly debilitating causing numbness, motor loss, may need to be stretched decompressed, or glided

Question 10

Probable Cause of Neural related pain

Answer 10

• Fusing with scaring, stenosis, disc hurniation with surrounding compression, nerve irritation with inflammation, demyelination, viral attack, post-surgical tightness

Question 11

Regauarding to nerve root pain

Answer 11

• If irritated; pain increases, reflexes increases, mm tone increases, myotome normal, sensation increases
• If compressed; pain none, reflexes decreased, mm tone decreased, myotome weakness, sensation decreased
• If between the two stages; pain is present but not severe, reflexes may be increased, mm tone may be increased, myotome is mixed, sensation is mixed

Question 12

Discogenic

Answer 12

• May be midline or peripheral, may occur in multiple bouts, may have significant increase in symptoms with shearing motion, will have one specific event that initiated symptoms, and pain will increase with motion towards the side of the injury

Question 13

Probable Cause of Discogenic

Answer 13

• Dis herniation, disc prolapse, annulus breech, vetebral end plate irritation

Question 14

Muscular Problem

Answer 14

• Will typically be gone by the time we see them, if rupture or tear, may need surgical intervention, pain with contractile activities, and c/o dull ache associated with inflammation

Question 15

Probable cause of muscular problem

Answer 15

• Muscle tear

Question 16

Painful and Strong

Answer 16

• Minor lesion of mm

Question 17

Painful and Weak

Answer 17

• Major lesion of mm

Question 18

Painless and weak

Answer 18

• Neuro lesion/complete rupture of mm

Question 19

Painless and Strong

Answer 19

• Normal

Question 20

Not all pain is ____ or ______ in nature or origin. Keep a broad and ____ list of ______. Do not miss the _____ case _______. DO NOT be _____ to ___ for _____ and or a ______ opinion

Answer 20

• Skeletal
• Muscular
• Dynamic
• Possibilities
• Worst
• Scenario
• Afraid
• Ask
• Help
• 2nd