Regeneración

Fortunately, most patients have pain of a mechanical nature, and the prognosis for a speedy recovery is outstan- ding. In such patients, usually the CAP will find a self-care exercise that is effective on day 1. A subset of mechanical patients have pain of postural origin and unless the tissue can be spared from prolonged static overload only mini- mal improvement will occur. Patients who have strained or injured their tissues will often have a chemical or inflam- matory component to their pain. Such patients have an

TABLE 5.5 Patient Categories Mechanical

Static overload—postural History alone reveals sensitivity Treatment: postural/ergonomic advice Prognosis: good

Dynamic overload

Examination shows mechanical sensitivity

Treatment: exercise to address the most relevant painless dysfunction

Within-session improvement expected Prognosis: excellent

Chemical

Examination shows mechanical sensitivity

Treatment: relative rest and deinflammation of tissues No within-session improvement expected

Prognosis: excellent, after a short delay Sensitization (central)

All movements are painful

Treatment: motor control and cognitive-behavioral training No within-session improvement expected

CHAPter 5 | tHe CLInICAL AudIt ProCess And determInIng tHe Key LInK 57

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