Rigakuryoho Kagaku

Assessment of Pain in Physical Therapy

Masashi ANDOU

2000 Volume 15 Issue 3 Pages 63-72
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.63

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Based on past reports on measurement and examination methods of pain assessment, this review especially introduces the assessment applicable to physical therapy treatment. The purposes of the assessment consist of 1) to know patient's complain objectively, 2) to examine the cause of pain, and 3) to measure the disorder degree of algesthesia function (pain threshold). For knowing patient's complain, pain should be analyzed by its degree, character, change with time and area. The cause of pain is examined by specification of tender points and pain induction by correction of posture or joint movements. As a measurement method of pain threshold, mechanical stimulus method, temperature stimulus method, chemical stimulus method, and electrical stimulus method are described.

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Physiology of Pain

Mieko KUROSAWA

2000 Volume 15 Issue 3 Pages 73-79
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.73

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Pain stems from a noxious stimulus such as tissue damage, and plays an important role in transmitting hazardous signals to the body. Nociceptors excited by a noxious stimulus have no specific receptor structures, and are considered primary afferent free nerve endings of Aδ and C fibers. Primary afferent fibers release transmitter substances in the posterior horn of the spinal cord, for example glutamic acid or substance P, and thereby excite secondary nociceptive neurons. The excitation ascends the spinal cord, is projected on to specific or non-specific nuclei of the thalamus, and is then projected on sensory areas of the cerebral cortex or the limbic system. Sense of pain, emotional responses, autonomic responses, and defence responses are then provoked. Inhibitory (relieving) system for pain is also observed in a living body.

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Autonomic Responses to Spinal Pain

Brian BUDGELL

2000 Volume 15 Issue 3 Pages 81-87
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.81

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On a broad scale, relief from current pain is probably the single most important consideration for our patients. However, physical pain is not the only component of a patient's suffering, and sometimes other aspects of a spinal pain syndrome are of equal or greater clinical importance. Pain in general, and perhaps spinal pain in particular, is capable of eliciting changes in visceral function which can be distressing and even dangerous. There might be various mechanisms through which such functional changes might occur, but the somatoautonomic reflex is probably the best understood. This paper will first discuss the mechanism of the somatoautonomic reflex and then examine whether evidence supports an important role for this phenomenon in spinal pain syndromes.

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Pain of Hip Joint and Functional Disorder

Hitoshi TANEDA

2000 Volume 15 Issue 3 Pages 89-94
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.89

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Hip joint has distinctive, characteristic structure and function, and is composed of soft (connective) tissues. A knowledge of local anatomy of the soft tissue is essential in clarifying cause of pain, thereby this review describing anatomical structure of hip joint. Pain of hip joint results in various functional disorders, such as gait disorder, limit of range of motion of hip joint, and decrease in muscle strength around hip joint. This review then introduces the causes of pain of each hip joint disorder, especially describing coxarthrosis, the most frequently encountered hip joint disorder.

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Pierrot's Teardrops

—How Do We Face Mental Pain ?—

Hiroshi IMAIZUMI

2000 Volume 15 Issue 3 Pages 95-98
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.95

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The mental damage gives us real pain at the time when we get through a crisis and can afford the realities of life, and few data exist on the mechanism and treatment method of mental pain. This review introduces my personal opinions on how I faced my mental pain, referring to the matters I learned by experience.

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Pain and Psychological Effect

Toshiyuki ISSHIKI

2000 Volume 15 Issue 3 Pages 99-103
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.99

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Pain should be understood not only by physical factors but also by psychological factors. Perception of pain highly correlated with emotion, and psychogenic pain, pain for no known physical cause, is occasionally observed. This review outlines the psychogenic pain from the viewpoints of ICD-10 and DSM-IV, and describes a psychological effect on phantom limb pain and chronic pain.

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Pain and Physical Agents

—Ultrasound and Electrical Stimulation—

Ken YAGAGISAWA

2000 Volume 15 Issue 3 Pages 105-110
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.105

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The review outlines the principles of the apparatus, characteristics and treatment methods of ultrasound and electrical stimulations, frequently applied in physical therapy for pain, and also refers to those of recent studies. As for ultrasound stimulation, the review describes a difference in frequency, intensity, beam non-uniformity ratio (BNR), cavitation, treatment area, and electrode transfer rate, and as for electric stimulation, it outlines the principles of the apparatuses and characteristics of percutaneous electric stimulation (TENS) and interference wave stimulation, as well as a basic theory of the pain inhibition.

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Manipulative Physical Therapy for Patients with Soft Tissue Disorders

Kazuo KUROSAWA

2000 Volume 15 Issue 3 Pages 111-115
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.111

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As one of the manipulative physical therapies, this communication reviews soft tissue mobilization, and describes the damage on soft tissue, clinical symptoms, and the treatment. Soft tissue mobilization is one of the treatments for soft tissue pain, and it is also mentioned that to know the patient's life habits and work which cause an overuse, and to administer appropriate guidance of daily life are essential for pain management.

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Nervous System Mobilization

Akihiko SAITO

2000 Volume 15 Issue 3 Pages 117-123
Published: 2000
Released on J-STAGE: March 29, 2007

DOIhttps://doi.org/10.1589/rika.15.117

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Nervous system is distributed in the whole body, and plays an integral role in transmitting information by physical, electrical and chemical means. Distributed in extremities and body trunk, nervous system possesses the mechanism flexibly adapted to physical movements. Injuries may damage this mechanism, leading to pain or limit of rage of motion. Although nervous system was the subject of examination and evaluation in the conventional physical therapy, nervous system mobilization consists of positive approaches suitable for each clinical symptom. This review outlines clinical symptoms of functional disorder of nervous system, and the methods of examination and treatment.

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