Self-Assessment Quiz Question #26 People with pulmonary pain often prefer to lie on the involved side because this puts pressure on the lungs and reduces respiratory movement and pain. The name for this is:
a. Stridor. b. Angina.
c. Autosplinting. d. Phrenic pain. Central sensitization and chronic neck pain
of patients with neck pain. As mentioned above, biopsychosocial factors that lead to central sensitization can exacerbate the pain experience and confound treatment. Cognitive–emotional factors have been shown to modulate the activity of descending brain pathways (Lam et al., 2018), so effective intervention in these instances might include pain neuroscience education aimed at decreasing the influence of cognitive–emotional drivers of pain. ● Sleep problems . The relationship between sleep quality and neck pain is bidirectional, as each can lead to the other. Literature suggests that insufficient quality and quantity of sleep are significantly associated with increased chances of having neck pain (Kazeminasab et al., 2022). ● Social support . Neck pain is associated with poor general social support (Kazeminasab et al., 2022). Healthcare consideration: Since depression is both a consequence of and causative factor for neck pain, the presence of the diagnosis of depression accompanying neck pain may require the assessing clinician to decide if action is warranted. Depression is considered an orange flag, that is, it is a diagnosis that can affect the ability to recover from neck pain. In this situation, the assessing clinician must consider at least two factors: (1) In their clinical judgement, does the depression diagnosis affect the onset and/or recovery from neck pain and (2) in their clinical judgement, is a referral to the appropriate healthcare provider warranted? While physical therapists might identify depression, they do not treat it. Referral to a psychologist or back to the referring physician might be an important part of helping the client get better. Self-Assessment Quiz Question #27 Which of the following cognitive factors has NOT been associated with the onset of neck pain? a. Catastrophizing. b. Active coping. Case Study: John Jackson Mr. Jackson is a 50-year-old postal worker who presents to physical therapy complaining of posterior and lateral neck pain. He states that his pain is minimal in the morning but gets worse throughout the day as he performs his mail sorting duties. He has noticeable tightness in the levator scapulae and upper trapezius muscles. When asked about his job duties, he reports that they have gotten much worse since he got a new boss a few months ago. He feels this boss has asked him to do more than he can handle. Question Can you name two possible different categories of factors that might explain this client’s neck pain? c. Low self-efficacy. d. Passive coping.
A study by Lam et al. (2018) found that patients with chronic neck pain demonstrate high levels of central sensitization. In fact, 62% of patients with chronic neck pain presented with signs of central sensitization. There were statistically significant associations between pain catastrophizing, fear of movement, and high perception of disability due to neck pain. When central sensitization and cooccurring biopsychosocial influences are present, these factors should be considered in the management Psychological factors and neck pain Neck pain is multifactorial, and the literature shows a clear link between psychological variables and neck pain (Kazeminasab et al., 2022). According to Kazeminasab et al. (2022), the following psychological factors are relevant to the onset of neck pain: ● Stress . Perceived stress is an identified risk factor for neck pain. Investigators have found that adolescents with neck pain had significantly higher stress levels than adolescents without neck pain. Also, permanent or regular feelings of stress were correlated with significantly increased reports of report neck pain. Stress may contribute to altered central pain processing at the spinal, brainstem, or cortical levels, resulting in enhanced pain sensitivity (Kazeminasab et al., 2022). ● Anxiety . Neck pain has been found to be comorbid with anxiety. Adolescents with neck pain were found to have higher levels of anxiety than adolescents without neck pain. In addition, anxiety disorders were found to be the second most common comorbid disease associated with neck pain (Kazeminasab et al., 2022). ● Depression . The relationship between depression and neck pain is bidirectional. In other words, people diagnosed with depression are more likely to develop neck pain, and people diagnosed with neck pain are more likely to develop depression. Literature suggests that the strongest psychosocial risk factors among individuals with chronic neck and back pain is depressed mood (Kazeminasab et al., 2022). ● Cognitive variables. Pain cognitions, such as catastrophizing, self-perceived poor health, fear-avoidance beliefs, and passive coping are related to increased pain such as neck pain. Low self-efficacy and low resilience have been shown to correlate with increased disability related to neck pain (Kazeminasab et al., 2022). Work factors and neck pain The work factor most commonly associated with neck pain is awkward/sustained postures. Workplace factors such as perceived high job demands, effort–reward imbalance, and lack of coworker support are all significant risk factors for the development of neck pain. Neck pain is also associated with low job control, routine work, lack of decision-making opportunities, low ability to influence working conditions, low job satisfaction, and high job strain (Kazeminasab et al., 2022).
Page 51
Book Code: PTNY1024
EliteLearning.com/ Physical-Therapy
Powered by FlippingBook