La. Admin. Code tit. 40 § I-2107

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-2107 - Definitions

A. Aftersensation refers to the abnormal persistence of a sensory perception, provoked by a stimulus even though the stimulus has ceased.

B. Allodynia is pain due to a non-noxious stimulus that does not normally provoke pain.

1. Mechanical Allodynia - refers to the abnormal perception of pain from usually non-painful mechanical stimulation.

2. Static Mechanical Allodynia - refers to pain obtained by applying a single stimulus such as light pressure to a defined area.

3. Dynamic Mechanical Allodynia - obtained by moving the stimulus such as a brush or cotton tip across the abnormal hypersensitive area.

4. Thermal Allodynia - refers to the abnormal sensation of pain from usually non-painful thermal stimulation such as cold or warmth.

C. Analgesia. Absence of pain in response to stimulation that would normally be painful.

D. Biopsychosocial. A term that reflects the multiple facets of any clinical situation; namely, the biological, psychological, and social situation of the patient.

E. Central Pain . Pain initiated or caused by a primary lesion or dysfunction in the central nervous system.

F. Central Sensitization. The experience of pain evoked by the excitation of non-nociceptive neurons or of nerve fibers that normally relay non-painful sensations to the spinal cord. This results when non-nociceptive afferent neurons act on a sensitized central nervous system (CNS). Experimental data suggest that pathways normally carrying pain signals themselves become overstimulated and/or fail to respond to inhibitory influences causing increased pain. An example is wind-up which occurs when cells in the dorsal horn of the spinal cord increase their rate of action potential discharge in response to repeated stimulation by nociceptors.

G. Dysesthesia . An abnormal sensation described by the patient as unpleasant. As with paresthesia, dysesthesia may be spontaneous or evoked by maneuvers on physical examination.

H. Hyperalgesia . Refers to an exaggerated pain response from a usually painful stimulation.

I. Hyperesthesia (positive sensory phenomenon). Includes allodynia, hyperalgesia, and hyperpathia. Elicited by light touch, pin prick, cold, warm, vibration, joint position sensation or two-point discrimination, which is perceived as increased or more.

J. Hyperpathia. A condition of altered perception such that stimuli which would normally be innocuous, if repeated or prolonged, result in severe explosive persistent pain.

K. Hypoalgesia. Diminished pain perception in response to a normally painful stimulus.

L. Hypoesthesia/Hypesthesia (negative sensory phenomena). diminished sensitivity to stimulation.

M. Malingering. Intentional feigning of illness or disability in order to achieve external incentives such as recreational drugs or money.

N. Myofascial Pain. A regional pain characterized by tender points in taut bands of muscle that produce pain in a characteristic reference zone.

O. Myofascial Trigger Point. A physical sign in a muscle which includes, exquisite tenderness in a taut muscle band; and referred pain elicited by mechanical stimulation of the trigger point. The following findings may be associated with myofascial trigger points: Local twitch or contraction of the taut band when the trigger point is mechanically stimulated; Reproduction of the patient's spontaneous pain pattern when the trigger point is mechanically stimulated; Weakness without muscle atrophy; and restricted range of motion of the affected muscle; and Autonomic dysfunction associated with the trigger point such as changes in skin or limb temperature.

P. Neuralgia . Pain in the distribution of a nerve or nerves.

Q. Neuritis . Inflammation of a nerve or nerves.

R. Neurogenic Pain . Pain initiated or caused by a primary lesion, dysfunction, or transitory perturbation in the peripheral or central nervous system.

S. Neuropathic Pain . Pain due to an injured or dysfunctional central or peripheral nervous system.

T. Neuropathy. A disturbance of function or pathological change in a nerve: in one nerve (mononeuropathy); in several nerves (mononeuropathy multiplex); or diffuse and bilateral (polyneuropathy). Neuropathy should be associated with objective findings such as consistent sensory abnormalities, consistent motor findings (e.g., weakness, atrophy, fasciculations, muscle cramping), and/or neuropathic abnormalities on EMG/nerve conduction testing.

U. Nociceptor. A receptor preferentially sensitive to a noxious stimulus or to a stimulus which would become noxious if prolonged.

V. Pain Behavior. The non-verbal actions (such as grimacing, groaning, limping, using visible pain relieving or support devices and requisition of pain medications, among others) that are outward manifestations of pain, and through which a person may communicate that pain is being experienced.

W. Pain Threshold. The smallest stimulus perceived by a subject as painful during laboratory testing. The term also loosely applies to the biological variation among human beings in sensing and coping with pain.

X. Paresthesia. An abnormal sensation that is not described as pain. It can be either a spontaneous sensation (such as pins and needles) or a sensation evoked from non-painful or painful stimulation, such as light touch, thermal, or pinprick stimulus on physical examination.

Y. Peripheral Neuropathic Pain. Pain initiated or caused by a primary lesion or dysfunction in the peripheral nervous system.

Z. Somatic Dysfunction: impaired or altered function of related components of the somatic (body framework) system which includes skeletal, arthrodial, and myofascial structures.

AA. Summation. Refers to abnormally painful sensation to a repeated stimulus although the actual stimulus remains constant. The patient describes the pain as growing and growing as the same intensity stimulus continues.

BB. Sympathetically Maintained Pain (smp). A pain that is maintained by sympathetic efferent pathways and is eliminated by blockade of these pathways. It is intensified by circulating catecholamines.

CC. Tender Points. Tenderness on palpation at a tendon insertion, muscle belly or over bone. Palpation should be done with the thumb or forefinger, applying pressure approximately equal to a force of 4 kilograms (blanching of the entire nail bed).

La. Admin. Code tit. 40, § I-2107

Promulgated by the Louisiana Workforce Commission, Office of Workers Compensation Administration, LR 37:1684 (June 2011), Amended LR 46198 (2/1/2020).

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.