![]() Research is ongoing to identify the sites and mechanisms of visceral nociception. 3 We do know the afferent supply to internal organs is in close proximity to blood vessels along a path similar to the sympathetic nervous system. Scientists have not found actual nerve fibers and specific nociceptors in organs. Proposed models are based on what is known about the somatic (nonvisceral) sensory system. The neurology of visceral pain is not well understood at this time. To help identify psychogenic sources of pain, discussions of conversion symptoms, symptom magnification, and illness behavior are also included in this chapter. It is important to know how to differentiate between these two sources of painful symptoms. Pain patterns from cancer can be very similar to what we have traditionally identified as psychogenic or emotional sources of pain. These patterns are discussed in greater detail later in this text (see Chapters 14 to 18).Ī large component in the screening process is being able to recognize the client demonstrating a significant emotional overlay. Pain patterns of the chest, back, shoulder, scapula, pelvis, hip, groin, and sacroiliac (SI) joint are the most common sites of referred pain from a systemic disease process. This information is then compared with presenting features of primary musculoskeletal disorders that have similar patterns of presentation. In the clinical decision-making process the therapist will evaluate information regarding the location, referral pattern, description, frequency, intensity, and duration of systemic pain in combination with knowledge of associated symptoms and relieving and aggravating factors. 2Įach section discusses specific pain patterns characteristic of disease entities that can mimic pain from musculoskeletal or neuromuscular disorders. Additional resources for understanding the mechanisms of pain are available. Information will include a discussion of pain types in general and viscerogenic pain patterns specifically. This chapter includes a detailed overview of pain patterns that can be used as a foundation for all the organ systems presented. Understanding how and when diseased organs can refer pain to the neuromusculoskeletal (NMS) system helps the therapist identify suspicious pain patterns. Recognizing pain patterns that are characteristic of systemic disease is a necessary step in the screening process. ![]() ![]() Pain is now recognized as the “fifth vital sign,” 1 along with blood pressure, temperature, pulse, and respiration. Pain assessment is a key feature in the physical therapy interview. Pain is often the primary symptom in many physical therapy practices. Pain Types and Viscerogenic Pain Patterns
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