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Day and Night Variation of Pain

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day and night variation of pain
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  Why do we need to know how much the weight she lifts?     There are maximum weights lifting for men and women . If applying these, no man should attempt to lift anything heavier than 25kg and a woman’s maximum limit is 16kg.   If lifting above shoulder height  (stocking high shelves for example) men should not lift items heavier than 10kg and women, 7kg but this maximum weight drops yet again for objects that need to be held away from the body  –  5kg for men and 3kg for women. But it’s important to take into account other factors  which can change the maximum safe weight  - such as how high  an object will need to be lifted. Employers should carry out risk assessments for all lifting since the safe limit depends on so many variables  such as the individual involved, the height  that you will be lifting and the distance  you will be required to carry the object. Never assume that because a larger workmate can lift an object without injury that it is a safe weight for you to attempt. Everyone is a different size and we all differ in body strength. Is the weight of the item within your physical capability? Have you been given reasonable rest periods between manual lifting tasks? Is there adequate space to lift safely? Biomechanics determines the loading on different parts of the body; the interplay between the body position, posture, load, gravity, and inertia need to be considered. http://www.workplacesafetyadvice.co.uk/guide-manual-handling-lifting-techniques.html    Discuss the reasons behind the day and night variation of pain. Pain is the most common presenting complaint. Chronology of the pain and aggravating factors provide clues to srcin. These include prior trauma for example, or even preceding infections causing reactive arthritis. Pain can be acute, for example, as in gout where the onset may be almost instantaneous or over hours, compared to pseudogout, which may occur over weeks and osteoarthritis, which can be gradual over years. Pain fluctuate over time.   The physician is looking for clues as to the etiology of the pain . Arthritic conditions  may be worse in the mornings and during cold seasons.   Reasons:   1)   barometric pressure    –  the force exerted by the weight of the atmosphere. Some researchers have proposed that a drop in barometric pressure, which tends to accompany cooler, damper weather, could allow tissues in joints to swell and put pressure on nerves that control pain signals.   2) The nervous system is essentially misbehaving ;  pain signals travelling along nerves from their  joint are amplified in the brain by signals carried on separate nerves called sympathetic nerves. These sympathetic nerves are part of the body's system for maintaining its internal functioning   without us having to think about it. When it's cold, these nerves constrict blood vessels in the limbs, to minimise heat loss and help keep warm the core of the body, where vital organs are. But the increased activation of these nerves around joints in response to cold weather might also lead to an increase in the pain a person feels, Vagg argues. http://www.helpforpain.com/articles/pain-assess/assessment.htm  Inflammatory pain  is usually maximal in the morning and increases again at the end of the day.  Mechanical pain is maximal with use, and activity. Night pain and rest pain may be frequently seen with bone diseases  suc h as Paget’s disease (     a localized disorder of bone remodeling that typically begins with excessive bone resorption followed by an increase in bone formation. ) , but also is seen with malignancy.    Prolonged immobilization of a joint  has been shown to cause several detrimental pathophysiologic findings including: decreased collagen length, fibrofatty infiltration into the capsular recess, ligament atrophy resulting in decreased stress absorption, collagen band bridging across recesses, random collagen production, and altered sarcomere number in muscle tissue  http://www.arthritis.co.za/the%20clinical%20examination%20technique.html  Discuss the reasons of stiffness of the shoulder in the morning. The duration of the stiffness , especially morning stiffness is proportional to the amount of inflammation . Degenerative process results in short duration morning or post rest stiffness. The stiffening of the joints is called gelling . Inflammatory disease  causes prolonged morning stiffness. In the case of Rheumatoid arthritis this usually exceeds an hour. In Polymyalgia, the stiffness is also typical in the morning and is usually proximal in the shoulder girdle, neck and thigh region. Sleeping posture  –  Poor pattern Sleeping on your side generally pushes the shoulder together on the side that you are lying on and the shoulder on top is generally being overstretched. In addition, our bodies are not designed to stay in certain positions for over extended periods of time. Staying in one position for a period of time can cause muscles to tighten up and cause stiffness in your shoulders in the morning.

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