통증 생리와 물리치료 원리
Pain Physiology and Principles of Physical Therapy
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The pain is common among individuals with physical disabilities. It can interfere withtherapy since patients with pain can become uncooperative and reluctant to move. Thispaper reviews the natural physiological mechanisms that can reduce pain perception, andconsiders physiological mechanisms which contribute to clinical pain by describing howthe pain system changes its sensitivity depending upon the body' s needs. The peripheraland central mechanisms contributing to sensitised nociceptive system are described withreference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous’on-going’-projected and referred pain. It is suggested that in some chronic pain thenociceptive system maintains a state of sensitivity despite the absence of on-going tissuedamage and under such circumstances the nociceptive system itself may have becomedysfunctional. Such situations are often initiated by damage to nervous tissue whichresults in changes in the activity and organization of neuronal circuits within the centralnervous system. The ability of the nociceptive system to operate in a suppressed state isalso discussed with reference to pain modulation. The physical therapist can helpfacilitate the activation of these mechanisms through a combination of noninvasivemodalities, functional activities, and the therapeutic use of self.
Abstract
The pain is common among individuals with physical disabilities. It can interfere withtherapy since patients with pain can become uncooperative and reluctant to move. Thispaper reviews the natural physiological mechanisms that can reduce pain perception, andconsiders physiological mechanisms which contribute to clinical pain by describing howthe pain system changes its sensitivity depending upon the body' s needs. The peripheraland central mechanisms contributing to sensitised nociceptive system are described withreference to the symptoms of clinical pain such as hyperalgesia, allodynia sopntaneous’on-going’-projected and referred pain. It is suggested that in some chronic pain thenociceptive system maintains a state of sensitivity despite the absence of on-going tissuedamage and under such circumstances the nociceptive system itself may have becomedysfunctional. Such situations are often initiated by damage to nervous tissue whichresults in changes in the activity and organization of neuronal circuits within the centralnervous system. The ability of the nociceptive system to operate in a suppressed state isalso discussed with reference to pain modulation. The physical therapist can helpfacilitate the activation of these mechanisms through a combination of noninvasivemodalities, functional activities, and the therapeutic use of self.