pain and pain gate theory.pptx
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The document discusses the gate control theory of pain. It proposes that a neural gate in the spinal cord can open and close to modulate pain perception. When the gate is closed by large-diameter nerve fiber activity, pain signals from small fibers are inhibited from reaching the brain. When the gate opens due to small fiber activity, pain perception increases. Factors like physical activity, relaxation, and positive moods can influence the gate and help manage pain.
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Pain gate theory
The gate control theory of pain proposes that a "gate" in the spinal cord can open and close to modulate pain perception. It suggests that non-painful stimuli can close the gate and inhibit pain transmission, while painful stimuli open the gate and facilitate pain transmission. Psychological factors are also thought to influence the gating mechanism by modulating the balance of activity between small and large diameter nerve fibers.
Pain gate theory
In physiotherapy pain gate pathway and pain control theory is important for the explanation behind the physiologic pain control.
Transcutaneous electrical nerve stimulation (TENS)
Saurab Sharma presented on Transcutaneous Electrical Nerve Stimulation (TENS). The objectives were to understand TENS theory, application techniques, uses, electrode placement, and precautions. TENS delivers electricity across the skin to activate nerves and provides pain relief for acute, chronic non-malignant, and palliative malignant pain. Different application techniques include high frequency, low frequency, brief intense, burst mode, and modulated TENS. Common uses are postoperative, labor, musculoskeletal, and neuropathic pain. Electrodes are placed over painful sites and precautions taken with pacemakers, malignancy, and skin conditions.
Pain gait theory
Gait control theory of pain given by Melzack & Wall in 1965. This is very much helpful for those medical/paramedical professionals who deal with subjects having pain.
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Basic of cryotherapy, its physiological effects,treatment modes indications,contraindications and use in sports injury rehabilitation....
Pain & Theories of Pain
This document provides an overview of pain theories and the Gate Control Theory of pain modulation. It defines pain and classifies types of pain fibers and pain. Several historical theories of pain are outlined. The bulk of the document focuses on explaining the Gate Control Theory proposed by Melzack and Wall in 1965. This theory proposes that a gating mechanism in the dorsal horn of the spinal cord regulates whether painful stimuli are transmitted to the brain based on the interplay between small nerve fibers carrying pain and large fibers carrying other sensations. When the gate is closed, pain is not perceived, and when open, pain signals pass through.
SD curve (Strength Duration Curve)
a detailed description on theory behind Strength duration curve, along with procedure for plotting SD Curve and measuring the Rheobase and Chronaxie of the plotted graph.
TENS
This document discusses T.E.N.S. (Transcutaneous Electrical Nerve Stimulation), a non-invasive pain management technique. It stimulates nerves under the skin to reduce pain signals according to the gate control theory. T.E.N.S. has efficacy rates of 50-80% for controlling chronic and acute pain, such as post-surgical or injury pain. Different T.E.N.S. techniques like high frequency, low frequency, and brief intense stimulation are described along with their parameters and applications. Placement of electrodes and contraindications are also covered.
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Pain gate theory
The gate control theory of pain proposes that a "gate" in the spinal cord can open and close to modulate pain perception. It suggests that non-painful stimuli can close the gate and inhibit pain transmission, while painful stimuli open the gate and facilitate pain transmission. Psychological factors are also thought to influence the gating mechanism by modulating the balance of activity between small and large diameter nerve fibers.
Pain gate theory
In physiotherapy pain gate pathway and pain control theory is important for the explanation behind the physiologic pain control.
Transcutaneous electrical nerve stimulation (TENS)
Saurab Sharma presented on Transcutaneous Electrical Nerve Stimulation (TENS). The objectives were to understand TENS theory, application techniques, uses, electrode placement, and precautions. TENS delivers electricity across the skin to activate nerves and provides pain relief for acute, chronic non-malignant, and palliative malignant pain. Different application techniques include high frequency, low frequency, brief intense, burst mode, and modulated TENS. Common uses are postoperative, labor, musculoskeletal, and neuropathic pain. Electrodes are placed over painful sites and precautions taken with pacemakers, malignancy, and skin conditions.
Pain gait theory
Gait control theory of pain given by Melzack & Wall in 1965. This is very much helpful for those medical/paramedical professionals who deal with subjects having pain.
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Pain & Theories of Pain
This document provides an overview of pain theories and the Gate Control Theory of pain modulation. It defines pain and classifies types of pain fibers and pain. Several historical theories of pain are outlined. The bulk of the document focuses on explaining the Gate Control Theory proposed by Melzack and Wall in 1965. This theory proposes that a gating mechanism in the dorsal horn of the spinal cord regulates whether painful stimuli are transmitted to the brain based on the interplay between small nerve fibers carrying pain and large fibers carrying other sensations. When the gate is closed, pain is not perceived, and when open, pain signals pass through.
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Theories of pain
The document discusses several theoretical frameworks that have been proposed to explain pain perception physiology. It outlines several theories including: the intensity/summation theory which defines pain as an emotion from excessive stimulation; the specificity theory which proposes pain receptors transmit signals to a pain center in the brain; and the pattern theory which suggests pain results from certain patterns of neural activity. It also describes Melzack and Wall's gate control theory, which proposes that large diameter fibers can open or close a 'gate' in the spinal cord to pain signal transmission from small fibers to the brain.
Goniometer
Goniometry is used to measure joint range of motion. There are different types of goniometers including universal, finger, and electro goniometers. To take an accurate measurement, the therapist positions the goniometer arms parallel to the longitudinal axis of the proximal and distal body parts, with the axis over the joint. Range of motion can then be measured actively or passively. Goniometry is used to assess limitations, track progress, and guide treatment for conditions affecting joint mobility.
MITCHELL’S RELAXATION TECHNIQUE
The document discusses Mitchell's relaxation technique, which uses diaphragmatic breathing and isotonic muscle contractions based on reciprocal inhibition. It can be used to treat respiratory, orthopedic, post-natal, and psychiatric conditions. The technique promotes relaxation and reduces muscle tension and pain perception. It is effective for pre-labor Braxton Hicks contractions and realigning stress-related postures by moving to a new position and increasing awareness of body position. Mitchell's relaxation technique can also help conditions involving a high tone pelvic floor like painful bladder syndrome.
Manual therapy.pps
Manual therapy techniques like joint mobilizations and manipulations can be used to safely restore normal joint mechanics and reduce trauma. Effective use requires knowledge of anatomy, arthrokinematics, and pathologies. Several concepts for manual therapy techniques were introduced, including Cyriax, Mulligan, Maitland, and McKenzie. Contraindications include inflammation, effusion, and hypermobility while indications include reversible hypomobility and functional limitations responding to mechanical treatment. Grading systems determine appropriate mobilization force and different joints require specific examination and treatment techniques.
Lecture 2 Electrotherapy- pain physiology
Knowledge of pain physiology is very important in understanding of electrotherapy prescription. So, this slide may be useful in understanding the background of the pain processes.
Hydrocollator pack
1. A hydro-collator pack is a fabric envelope containing silica gel or bentonite crystal packs that are heated in a hydro-collator unit to provide moist heat therapy.
2. The hydro-collator unit maintains water at 70-80°C to heat the packs for 30-40 minutes of moist heat application.
3. When applied with adequate toweling insulation, hydro-collator packs provide penetrating heat therapy above 75°C without raising skin temperature excessively, helping to reduce pain, muscle spasm, and inflammation.
Rebox current
Rebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.
Diadynamic currents
Diadynamic currents are a variation of sinusoidal currents that are produced by rectifying alternating current into monophasic pulses. There are two main types - half wave rectification produces pulses with a duration equal to the interpulse interval at the original frequency, while full wave rectification produces continuous pulses at twice the original frequency. The pulses from diadynamic currents have a duration of 10ms, causing sensations from vibration to pain depending on intensity. Different current types like MF, DF, CP and LP are used for pain relief, muscle stimulation, and preventing accommodation effects. Precautions must be taken due to the electrochemical changes and potential skin damage from the currents.
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Interferential Therapy (IFT)
This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.
Galvanic current
This document discusses galvanic current and its use in stimulating denervated muscles. It defines galvanic current as a direct, unidirectional current that can cause pain due to its unidirectional nature. Interrupted galvanic current is introduced to overcome this by providing regular pauses in stimulation. Stimulating denervated muscles with galvanic current can help limit atrophy and edema until reinnervation occurs. Precautions must be taken when applying galvanic current due to potential dangers like burns or electric shock.
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Cryotherapy
Cryotherapy involves applying cold to the body for therapeutic purposes. It uses cooling agents like ice, frozen gel, or vapocoolant sprays. The cold induces vasoconstriction which reduces blood flow, lowering metabolic rate and inhibiting inflammation. It also increases pain threshold and reduces muscle spasm. Cryotherapy can relieve pain, reduce swelling and spasticity, facilitate muscle contraction, and promote tissue repair. Contraindications include cardiac conditions, peripheral nerve injury, and cold sensitivity. Common application techniques are ice towels, ice packs, immersion, and ice cube massage.
Laser therapy (physiotherapy)
Laser therapy uses low-level lasers that emit coherent light to induce biological effects in tissues. It was first developed in the 1960s and approved by the FDA in 2002 to treat carpal tunnel syndrome. Lasers are classified based on their power output and potential hazards, with classes 1 and 2 being safe for therapeutic use. Common types include helium-neon and gallium arsenide lasers. Physiological effects include reducing pain and inflammation, promoting tissue healing, and recovery from nerve injuries through various cellular mechanisms like increased ATP and growth factor production.
SOFT TISSUE MANIPULATION.pptx
Therapeutic massage involves manipulating the soft tissues of the body through techniques like effleurage, petrissage, friction, tapotement, and vibration. The goals are to increase flexibility and blood flow, decrease pain, stimulate circulation, and facilitate healing. Massage provides mechanical, physiological and psychological benefits such as reduced muscle tension, improved circulation and range of motion, and lowered stress levels. It is used to treat conditions like muscle spasms, bursitis and tendonitis. Contraindications include acute injuries, infections, blood clots and incomplete fractures.
Low Frequency Therapeutic Currents
The document provides information on different types of low frequency therapeutic currents, including:
1) Faradic current, which is a short-duration interrupted current ranging from 0.1-1 msec at 50-100 Hz, used to produce near normal muscle contraction and relaxation.
2) Galvanic current, which is a direct current that flows continuously in one direction, and an interrupted form used for denervated muscle stimulation.
3) Sinusoidal currents, which are evenly alternating 50 Hz waves similar to mains current, providing 100 pulses per second.
4) Diadynamic currents, which are variations of sinusoidal currents involving single or double-phase rectification of alternating current produced
S d curve
The document discusses strength duration curves, which plot the electrical stimuli needed to elicit a muscle contraction over a range of stimulus durations. It describes how to perform the test and interpret the results, including details on:
- Plotting S-D curves after 20 days post-injury to assess innervation status
- The typical shape of normal, denervated, and partially denervated curves
- Additional metrics that can be measured from S-D curves like rheobase and chronaxie
- Factors that can influence the curves and what different curve patterns indicate
Interferential therapy
This document discusses interferential therapy (IFT), including its history, principles, instrumentation, applications, effects, and precautions. Some key points:
- IFT was developed in the 1950s and involves applying two medium frequency alternating currents slightly out of phase to produce a low frequency effect for therapeutic purposes.
- The interference of the currents produces an amplitude-modulated frequency that can stimulate tissues in a manner similar to low frequency electrotherapy.
- IFT is used for pain relief, muscle stimulation, increasing blood flow, and reducing edema through its physiological effects on tissues from 10-150 Hz.
- Proper electrode placement and current parameters are important to achieve the intended effects while avoiding contraindic
pain
Pain as an unpleasant emotional experience usually initiated by a noxious stimulus and transmitted over a specialized neural network to the central nervous system where it is interpreted as such
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MITCHELL’S RELAXATION TECHNIQUE
The document discusses Mitchell's relaxation technique, which uses diaphragmatic breathing and isotonic muscle contractions based on reciprocal inhibition. It can be used to treat respiratory, orthopedic, post-natal, and psychiatric conditions. The technique promotes relaxation and reduces muscle tension and pain perception. It is effective for pre-labor Braxton Hicks contractions and realigning stress-related postures by moving to a new position and increasing awareness of body position. Mitchell's relaxation technique can also help conditions involving a high tone pelvic floor like painful bladder syndrome.
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Manual therapy techniques like joint mobilizations and manipulations can be used to safely restore normal joint mechanics and reduce trauma. Effective use requires knowledge of anatomy, arthrokinematics, and pathologies. Several concepts for manual therapy techniques were introduced, including Cyriax, Mulligan, Maitland, and McKenzie. Contraindications include inflammation, effusion, and hypermobility while indications include reversible hypomobility and functional limitations responding to mechanical treatment. Grading systems determine appropriate mobilization force and different joints require specific examination and treatment techniques.
Lecture 2 Electrotherapy- pain physiology
Knowledge of pain physiology is very important in understanding of electrotherapy prescription. So, this slide may be useful in understanding the background of the pain processes.
Hydrocollator pack
1. A hydro-collator pack is a fabric envelope containing silica gel or bentonite crystal packs that are heated in a hydro-collator unit to provide moist heat therapy.
2. The hydro-collator unit maintains water at 70-80°C to heat the packs for 30-40 minutes of moist heat application.
3. When applied with adequate toweling insulation, hydro-collator packs provide penetrating heat therapy above 75°C without raising skin temperature excessively, helping to reduce pain, muscle spasm, and inflammation.
Rebox current
Rebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.
Diadynamic currents
Diadynamic currents are a variation of sinusoidal currents that are produced by rectifying alternating current into monophasic pulses. There are two main types - half wave rectification produces pulses with a duration equal to the interpulse interval at the original frequency, while full wave rectification produces continuous pulses at twice the original frequency. The pulses from diadynamic currents have a duration of 10ms, causing sensations from vibration to pain depending on intensity. Different current types like MF, DF, CP and LP are used for pain relief, muscle stimulation, and preventing accommodation effects. Precautions must be taken due to the electrochemical changes and potential skin damage from the currents.
Shortwave diathermy
The History of SWD
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Introduction to micro current
Micro-current is a treatment that uses a very small electrical current to stimulate cellular activity and speed up metabolism in tissues. It can tighten skin, reduce wrinkles and lines, and lift sagging muscles. A full course of micro-current treatments involves 10-12 sessions over 5-6 weeks, with different wave forms and programs targeting circulation, lymph drainage, lifting, and firming. Regular micro-current can help delay the signs of aging by promoting collagen and elastin production.
Interferential Therapy (IFT)
This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.
Galvanic current
This document discusses galvanic current and its use in stimulating denervated muscles. It defines galvanic current as a direct, unidirectional current that can cause pain due to its unidirectional nature. Interrupted galvanic current is introduced to overcome this by providing regular pauses in stimulation. Stimulating denervated muscles with galvanic current can help limit atrophy and edema until reinnervation occurs. Precautions must be taken when applying galvanic current due to potential dangers like burns or electric shock.
Transcutaneous Electrical Nerve Stimulation (TENS) SRS
Transcutaneous Electrical Nerve Stimulation (TENS) is a method of electrical stimulation that aims to provide pain relief by exciting sensory nerves and stimulating the pain gate mechanism and/or opioid system. TENS works through several mechanisms including activation of pain-gating mechanisms in the spinal cord and stimulation of the descending pain suppression system and endogenous opioid release. Different TENS waveforms, frequencies, pulse widths and intensities can be used depending on the type of pain and desired effects. Common types of TENS include conventional high frequency TENS and acupuncture-like low frequency TENS. Care must be taken with electrode placement and TENS is generally contraindicated for those with pacemakers or heart conditions.
Cryotherapy
Cryotherapy involves applying cold to the body for therapeutic purposes. It uses cooling agents like ice, frozen gel, or vapocoolant sprays. The cold induces vasoconstriction which reduces blood flow, lowering metabolic rate and inhibiting inflammation. It also increases pain threshold and reduces muscle spasm. Cryotherapy can relieve pain, reduce swelling and spasticity, facilitate muscle contraction, and promote tissue repair. Contraindications include cardiac conditions, peripheral nerve injury, and cold sensitivity. Common application techniques are ice towels, ice packs, immersion, and ice cube massage.
Laser therapy (physiotherapy)
Laser therapy uses low-level lasers that emit coherent light to induce biological effects in tissues. It was first developed in the 1960s and approved by the FDA in 2002 to treat carpal tunnel syndrome. Lasers are classified based on their power output and potential hazards, with classes 1 and 2 being safe for therapeutic use. Common types include helium-neon and gallium arsenide lasers. Physiological effects include reducing pain and inflammation, promoting tissue healing, and recovery from nerve injuries through various cellular mechanisms like increased ATP and growth factor production.
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Therapeutic massage involves manipulating the soft tissues of the body through techniques like effleurage, petrissage, friction, tapotement, and vibration. The goals are to increase flexibility and blood flow, decrease pain, stimulate circulation, and facilitate healing. Massage provides mechanical, physiological and psychological benefits such as reduced muscle tension, improved circulation and range of motion, and lowered stress levels. It is used to treat conditions like muscle spasms, bursitis and tendonitis. Contraindications include acute injuries, infections, blood clots and incomplete fractures.
Low Frequency Therapeutic Currents
The document provides information on different types of low frequency therapeutic currents, including:
1) Faradic current, which is a short-duration interrupted current ranging from 0.1-1 msec at 50-100 Hz, used to produce near normal muscle contraction and relaxation.
2) Galvanic current, which is a direct current that flows continuously in one direction, and an interrupted form used for denervated muscle stimulation.
3) Sinusoidal currents, which are evenly alternating 50 Hz waves similar to mains current, providing 100 pulses per second.
4) Diadynamic currents, which are variations of sinusoidal currents involving single or double-phase rectification of alternating current produced
S d curve
The document discusses strength duration curves, which plot the electrical stimuli needed to elicit a muscle contraction over a range of stimulus durations. It describes how to perform the test and interpret the results, including details on:
- Plotting S-D curves after 20 days post-injury to assess innervation status
- The typical shape of normal, denervated, and partially denervated curves
- Additional metrics that can be measured from S-D curves like rheobase and chronaxie
- Factors that can influence the curves and what different curve patterns indicate
Interferential therapy
This document discusses interferential therapy (IFT), including its history, principles, instrumentation, applications, effects, and precautions. Some key points:
- IFT was developed in the 1950s and involves applying two medium frequency alternating currents slightly out of phase to produce a low frequency effect for therapeutic purposes.
- The interference of the currents produces an amplitude-modulated frequency that can stimulate tissues in a manner similar to low frequency electrotherapy.
- IFT is used for pain relief, muscle stimulation, increasing blood flow, and reducing edema through its physiological effects on tissues from 10-150 Hz.
- Proper electrode placement and current parameters are important to achieve the intended effects while avoiding contraindic
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Pain definition, pathway,analgesic pathway, types of pain
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Pain definition, pathway,analgesic pathway
an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
Pain pathways
The document discusses pain pathways and mechanisms. It defines pain and describes the different types of pain receptors and fibers that detect pain. The dual nature of pain as both a sensory and emotional experience is explained. Several theories of pain mechanisms are presented, including the specificity theory, pattern theory, and gate control theory. The gate control theory proposes that activity in large nerve fibers inhibits transmission of pain signals while activity in small fibers facilitates transmission. Neurotransmitters and chemical mediators involved in pain signaling are also discussed.
pain
Definition n classification •Pathophysiologyof pain. •Physiological Effects of pain. •Pharmacological & non-pharmacological methods of analgesia. •Principles of pain management.METHODS OF CONTROLLING METHODS OF CONTROLLING
Non-pharmacological Preoperative counseling TENS Acupuncture
Pharmacological Opioids •Im •IV infusion •IV PCA Local anaesthetics: •Local Infiltration •Nerve Blocks •Epidural Blocks NSAIDS •IM •IV infusion •IV PCA
NON-PHARMACOLOGICAL METHODS PRE-OP COUNSELLING: Well informed patients about: •Nature of operation •Nature of post operative pain •Methods of analgesia available
Cope better with Post –op Pain
NON-PHARMACOLOGICAL METHODS TENS (Trans Cutaneous electric nerve stimulation)
Stimulates afferent myelinated (A-beta) nerve fibers at 70hz
Inhibitory circuits within sp cord activated
Nerve impulse transmission reduced
Maximum benefit in neurogenic pain
PHARMACOLOGICAL METHODS OPIODS •Activate opiodreceptors within the CNS •Reduce transmission of nerve impulses by modulation in the dorsal horn
PHARMACOLOGICAL METHODS
LOCAL ANAESTHETICS –Blocks the conduction of nerve impulses –Can be given with adrenaline because •Decreases absorption of L.A allowing larger doses •Also acts on alpha 2 receptors which potentiates analgesic effect
PHARMACOLOGICAL METHODS
NASIDS –Blocks synthesis of PG’s –Only suitable for miledto moderate pain
PRINCIPLE OF MANAGEMENT OF PAIN •Pre-emptive analgesia •Balanced or combination analgesia •Analgesia ladder
PHARMACOLOGICAL METHODS
Balanced Analgesia –NASID are used in conjunction with opioids. –Reduces amount of opioids –Reduces side affect of opioids,ASSESMENT OF PAIN •Observe the behaviour of the patient •Monitor analgesic requirement of the patient –Visual Analogue Score( VAS )
–Verbal Rating Score ( VRS ) •None •Mild •Moderate •severe
Pain.
The document discusses pain perception and transmission in the human body. It begins by defining pain and outlining the dual sensory and emotional nature of pain. It then describes how pain signals are transmitted from nociceptors to the spinal cord and brain through A and C nerve fibers. The signals travel through the spinothalamic tract to the thalamus and somatosensory cortex. Descending pathways from the brain can modulate pain perception. The gate control theory of pain is also explained. The document further discusses different types of pain and factors that influence pain experience.
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- 1. PAIN AND PAIN GATE THEORY Presented by: Priyanka Bhusal
- 2. Pain is defined as unpleasant sensory and emotional experience associated with actual or potential tissue damage.
- 3. Gate control theory was described by Melzack and Wall in 1965. This theory explains about a pain- modulating system in which a neural gate present in the spinal cord can open and close thereby modulating the perception of pain.
- 4. 1. The substantia gelatinosa in the dorsal horn 2. The dorsal column fibers 3. The central transmission cells.
- 5. The dorsal horn is responsible for passing on information which can be interpreted as pain. This area is referred to as the 'gate' as it prevents the brain from receiving too much information too quickly. GATE= Dorsal horn
- 6. Primary: from the ‘nociceptors’ to the dorsal horn of the spinal cord. Secondary: from the dorsal horn to the thalamus. Tertiary: from thalamus to cortex and awareness.
- 7. The smaller, unmyelenated A (delta) and C nerve fibers sense pain such as sharp burning and aching feelings. Larger, myelenated A (beta) skin nerves which carry senses of touch, heat, cold and pressure. • The A (beta) nerves are faster, and also have priority which effectively blocks out the pain messages to the brain and closes the gate.
- 8. Stimulation of the large-diameter fibers (A-Fibers) activates inhibitory interneuron which inhibits the transmission of pain (closing the gate). Stimulation of the Small-diameter fibers (C- Fibers) stimulates the transmission of pain (opening the Gate). When the gate is closed, signals from small diameter pain fibers do not excite the dorsal horn transmission neurons. When the gate is open pain signals excite dorsal horn transmission cells. The gating mechanism is influenced by nerve impulses that descend from the brain.
- 10. 1. The amount of activity in the pain fibers. 2. The amount of activity in other peripheral fibers 3. Messages that descend from the brain.
- 11. 1. Physical Pain - Analgesic Remedies 2. Emotional Pain - Being in a ‘good’ mood 3. Behavioral Factors - Concentrating on things other than the injury 4. Relaxation and Contentment 5. Mental factors: work, T.V., book, 6. Activity - Taking exercise 7. counter-stimulation- heat, massage, acupuncture
- 12. Physical Factors - Bodily injury Emotional Factors - Anxiety & Depression Behavioral Factors - Attending to the injury and concentrating on the pain Lack of Activity