PAS Pain Assessment & Management 3 ā Questions and Answers
Question 1: A client with chronic low back pain displays catastrophizing thoughts about their condition. This cognitive pattern is BEST addressed by:
- Increasing exercise intensity immediately
- Ignoring the client's concerns and continuing the session
- Acknowledging concerns and referring to a mental health professional if appropriate (Correct answer)
- Reducing all physical activity indefinitely
Correct answer: Acknowledging concerns and referring to a mental health professional if appropriate
Pain catastrophizing is a psychosocial factor that warrants empathetic acknowledgment and possible referral to mental health support within the specialist's scope.
Question 2: Referred pain from the lumbar spine into the posterior thigh and calf follows which nerve root distribution?
- L2āL3 dermatome
- L4āS1 dermatome (sciatic distribution) (Correct answer)
- C5āC6 dermatome
- T10āT12 dermatome
Correct answer: L4āS1 dermatome (sciatic distribution)
The sciatic nerve, formed from L4āS1, distributes pain along the posterior thigh and into the calf when compressed or irritated.
Question 3: A client's pain is described as a constant 4/10 that is not affected by any posture or movement. This presentation is called:
- Mechanical pain
- Non-mechanical pain (Correct answer)
- Referred pain
- Myofascial pain
Correct answer: Non-mechanical pain
Non-mechanical pain does not change with posture or movement and may indicate systemic, visceral, or serious pathology requiring medical evaluation.
Question 4: Which assessment tool uses body diagrams to help clients map the location and distribution of their pain?
- Visual Analog Scale (VAS)
- Body Pain Diagram (Correct answer)
- Oswestry Disability Index
- Numerical Rating Scale (NRS)
Correct answer: Body Pain Diagram
A body pain diagram allows clients to shade or mark areas of pain, providing a visual map of pain distribution useful for identifying patterns.
Question 5: Centralization of pain during movement assessmentāwhere peripheral pain moves toward the spineāis a sign that the assessment is:
- Worsening the condition and should be stopped
- Indicating a positive response suggesting a mechanical cause of pain (Correct answer)
- Confirming neural tension
- Irrelevant to postural alignment work
Correct answer: Indicating a positive response suggesting a mechanical cause of pain
Centralization is a positive prognostic indicator in mechanical pain, suggesting the movement is beneficial and loading the spine appropriately.
Question 6: Which of the following is considered a 'yellow flag' in pain assessment?
- Fever accompanying low back pain
- Saddle anesthesia and bladder dysfunction
- A client's belief that pain means damage and all activity should stop (Correct answer)
- Significant trauma preceding the onset of pain
Correct answer: A client's belief that pain means damage and all activity should stop
Yellow flags are psychosocial risk factorsāsuch as unhelpful beliefs about paināthat predict delayed recovery and chronic disability.
Question 7: A PAS specialist notices a client guards their right hip and walks with a lateral trunk lean toward that side. This compensatory gait pattern most likely indicates:
- Hip abductor weakness contralateral to the lean
- Pain or pathology on the side toward which the trunk leans (Correct answer)
- Thoracic scoliosis causing gait asymmetry
- Normal postural variation with no clinical significance
Correct answer: Pain or pathology on the side toward which the trunk leans
Leaning toward the painful side (antalgic lean) offloads compressive forces on the hip joint, reducing pain during weight-bearing.
PAS Pain Assessment & Management 3
A client with chronic low back pain displays catastrophizing thoughts about their condition.
This cognitive pattern is BEST addressed by: