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Is there a Relationship between Referred Pain and Inflammation?
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Abstracts: Congress 2002 Free paper sessions, posters and programmes mounted by eight of the Chartered Society of Physiotherapy’s Specific Interest Groups were primary features of the Annual Congress held on October 11 to 13, 2002, in Birmingham. More than 1,000 members attended the Congress, and speakers included professionals from many disciplines, including orthopaedic surgeons, a podiatrist, a dietician, a psychologist, an ergonomist and a barrister. Summaries of five free papers are given here, followed by a selection of poster abstracts.
FREE PAPERS
Is there a Relationship between Referred Pain and Inflammation? Stephanie Mulhearn University College London Introduction It is suggested that for referred pain to exist, central sensitisation must occur within the dorsal horn. There is evidence that a slowly developing and maintained increase in excitability of central neurones occurs in inflammatory states due to the increased afferent barrage of C fibre nociceptive input. The development of referred pain seems to be closely associated with inflammation, highlighting that inflammation may be an important indicator to predict the development of referred pain. The aim of this review was to search for information on inflammatory predictors of referred pain and use of antiinflammatory agents in prevention of referred pain.
‘development of’, ‘cortico-steroids and NSAIDS’, ‘inflammation’, ‘pain patterns’ and ‘central sensitisation’.
Method A literature search using Medline, Embase, Amed and pain management text was made between 1985 and 2002 using the term ‘referred pain’ cross-referenced with
Conclusion In contrast to the physiological literature no clinical evidence was found which showed a relationship between inflammation and referred pain.
Results There were no studies predicting the development of referred pain. Pain management text revealed that both cortico-steroids and NSAIDS are highlighted as having a possible role in reducing central sensitisation, however no clinical studies were found to support this theory. Discussion Physiological text indicates that central sensitisation and inflammation are closely associated and yet unfortunately there are very few clinical studies to support this theory or linking cortico-steroids to prevention of referred pain.
Accessibility and the Web Ensuring that web materials are accessible to visually impaired users Rachel Chester, Joanne Bruce University of East Anglia; Norfolk and Norwich University Hospital Introduction Developments in information technology support the production of teaching and learning material in a new range of formats. This project aimed to produce and to document the production of a website as a resource for teaching musculoskeletal practice to undergraduate physiotherapy students, accessible to students with visual impairment. Method Information on web design and accessibility was gathered from diverse scholarly, research and commercial sources. To the inexperienced web designer this information is often detailed, complex and difficult to apply. Physiotherapy March 2003/vol 89/no 3
Using a case study, the basic principles of accessibility to websites were identified and the problems and solutions highlighted. Feedback was achieved via the use of screen readers and local users. Findings/analysis The website was Bobby-approved. A basic set of guidelines was produced for those new to website design. Placing teaching material on the website enabled students with visual impairment to access and read material independently. Discussion Screen reader software now enables written material to be translated into the spoken word. However for this to occur in relation to websites software application is
Abstracts: Congress 2002 Free paper sessions, posters and programmes mounted by eight of the Chartered Society of Physiotherapy’s Specific Interest Groups were primary features of the Annual Congress held on October 11 to 13, 2002, in Birmingham. More than 1,000 members attended the Congress, and speakers included professionals from many disciplines, including orthopaedic surgeons, a podiatrist, a dietician, a psychologist, an ergonomist and a barrister. Summaries of five free papers are given here, followed by a selection of poster abstracts.
FREE PAPERS
Is there a Relationship between Referred Pain and Inflammation? Stephanie Mulhearn University College London Introduction It is suggested that for referred pain to exist, central sensitisation must occur within the dorsal horn. There is evidence that a slowly developing and maintained increase in excitability of central neurones occurs in inflammatory states due to the increased afferent barrage of C fibre nociceptive input. The development of referred pain seems to be closely associated with inflammation, highlighting that inflammation may be an important indicator to predict the development of referred pain. The aim of this review was to search for information on inflammatory predictors of referred pain and use of antiinflammatory agents in prevention of referred pain.
‘development of’, ‘cortico-steroids and NSAIDS’, ‘inflammation’, ‘pain patterns’ and ‘central sensitisation’.
Method A literature search using Medline, Embase, Amed and pain management text was made between 1985 and 2002 using the term ‘referred pain’ cross-referenced with
Conclusion In contrast to the physiological literature no clinical evidence was found which showed a relationship between inflammation and referred pain.
Results There were no studies predicting the development of referred pain. Pain management text revealed that both cortico-steroids and NSAIDS are highlighted as having a possible role in reducing central sensitisation, however no clinical studies were found to support this theory. Discussion Physiological text indicates that central sensitisation and inflammation are closely associated and yet unfortunately there are very few clinical studies to support this theory or linking cortico-steroids to prevention of referred pain.
Accessibility and the Web Ensuring that web materials are accessible to visually impaired users Rachel Chester, Joanne Bruce University of East Anglia; Norfolk and Norwich University Hospital Introduction Developments in information technology support the production of teaching and learning material in a new range of formats. This project aimed to produce and to document the production of a website as a resource for teaching musculoskeletal practice to undergraduate physiotherapy students, accessible to students with visual impairment. Method Information on web design and accessibility was gathered from diverse scholarly, research and commercial sources. To the inexperienced web designer this information is often detailed, complex and difficult to apply. Physiotherapy March 2003/vol 89/no 3
Using a case study, the basic principles of accessibility to websites were identified and the problems and solutions highlighted. Feedback was achieved via the use of screen readers and local users. Findings/analysis The website was Bobby-approved. A basic set of guidelines was produced for those new to website design. Placing teaching material on the website enabled students with visual impairment to access and read material independently. Discussion Screen reader software now enables written material to be translated into the spoken word. However for this to occur in relation to websites software application is