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Assessment and Measurement. The effective Rx of Myofascial Pain begins with defining the Tissue and or Reflex that is maintaining the Pain State. Find the ‘Active Trigger Point’ Assess sympathetic involvement. Trigger Points. Before being able to effectively treat

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Assessment and Measurement

The effective Rx of Myofascial Pain begins with defining the Tissue and or Reflex that is maintaining the Pain State.

Find the ‘Active Trigger Point’

Assess sympathetic involvement


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Trigger Points

Before being able to effectively treat

(and evaluate that treatment’s efficacy) the Trigger Point must first be

  • Identified!

  • Quantified!

  • Its associated reflexes delineated


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Pain Assessment Tools

Lord Kelvin 1824 -1907

“When you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot measure it, your knowledge is of a meager unsatisfactory kind: It may be the start of knowledge, but you have scarcely in your thoughts, advanced to the stage of science.”


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Pain Assessment Tools

“One of the most dramatic

developments in pain research

and therapy has been the recent

proliferation of techniques for the

measurement and assessment of

Pain” R. Melzack


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Pain Assessment

Every patient complaining of chronic pain deserves to be examined.

Palpation and the utilisation of pain assessment

tools including: Pain Diagrams, the McGill Pain

Questionnaire, Visual Analogue Pain Scale are

all a necessary part of this process.( And should

always be carried out before referral for

psychologically based therapies.)


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Pain Assessment ToolsRarely Used

CMAE Pilot Study: 14 Australian GP’s

129 Pain Patient Consultations.

Pain Diagram ..............8%

VAS............................. 9%

McGill ......................... 2%

[ No Patient had all three tools, 2 had VAS plus the McGill Questionnaire]


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Pain Assessment ToolsRarely Used

Australian journal of Physiotherapy1996

The assessment of pain: an audit of physiotherapy practice. ( NE England)

  • 921 cases, 21% were quantified in some way.....

  • Only 2.5% of 723 who were re-evaluated following Rx had their pain quantified....


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Myofascial Pain Syndrome Assessment- Tool Kit

Subjective

  • Visual Analogue Scale ( VAS )

  • McGill Pain Questionnaire

  • Pain Diagram

    Objective

  • Pressure Threshold Algometry

  • Differential Local Anesthetic Blocks

  • Thermography, EMG etc.


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Visual Analogue Scale

  • The VAS is a simple robust pain measurement tool

  • It can be used to measure severity & or Improvement

  • It can be reliably used for children over the age of five

  • The VAS is usually designed as a 10cm line with descriptors at each end.


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Visual Analogue Scale

The VAS for Pain severity measurement

No Pain Worst Possible Pain

The VAS for Treatment Effect

No Pain Complete Pain

Relief Relief


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Visual Analogue Scale

No Pain Worst Possible Pain

The example shows a patient recording a 9.0

i.e. The patient has made a mark 9cms from the no pain end

of the scale.

NB The VAS can be compromised if descriptors or numbers are added between the end points.

{The 10 cm line allows for easy measurement and recording}



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The short form McGill Pain Questionnaire

Sensory Dimension

Affective D.


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PAIN

DIAGRAMS

Pain Diagrams


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Myofascial Pain Syndrome

Subjective AssessmentTool Kit

Developed at the

10 High Street Pain Clinic.

Please copy and use it


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