Our understanding of how the brain changes in response to chronic pain or to pharmacologic or other therapeutic interventions has been significantly improved as a result of neuroimaging techniques. If pain persists or becomes chronic it can even change the circuitry in the central nervous system. If an acute pain sensation is intense enough, it can cause system-wide responses: increased alertness focused attention the suppression of feeding, sleep, and reproduction and increased vascular tone, respiration, and blood sugar levels. Pain of thermal origin is the result of excessive heat or cold. Medications are usually a part of the management regimen for chemical or inflammatory pain. It is often constant but responds to positioning, therapy, rest, and gentle movement. Pain of chemical or inflammatory origin is associated with arthritis and other inflammatory disorders. It may be constant, variable, or intermittent in nature and is affected by movement and position. Pain of mechanical origin can be caused by acute trauma, injury, or overuse. Pain can be caused by a mechanical, chemical or inflammatory, or thermal mechanism. Rather than ascending to the thalamus however, spinoreticular neurons terminate within the brainstem. The spinoreticular tract is similar to the spinothalamic tract in that it is excited by similar sensory fibers. This spinal tract transmits sensory information related to pain, temperature, and crude touch.Īnother prominent pathway is the spinoreticular tract, which is involved in nociceptive processing. One of the most important central pain pathways is the spinothalamic tract, which originates in the spinal cord and extends to the thalamus. A-delta fibers, which are myelinated and thus conduct impulses rapidly, respond to mechanical (pressure) stimulus and produce the sensation of sharp, localized, fast pain. They respond to thermal, mechanical, and chemical stimuli and produce the sensation of dull, diffuse, aching, burning, and delayed pain. The C fibers are small and conduct impulses slowly. The brainstem reticular formation, which forms a diffuse, central core within the brainstem is the destination of the spinoreticular tract. The thalamus is the destination of spinothalamic tract-the sensory pathway responsible for processing pain, temperature, and crude touch. Remote physiologic monitoring (RPM) is a set of codes that describes non-face-to-face monitoring and analysis of physiologic factors used to understand a patient’s health status.Destinations of the Spinothalamic and Spinoreticular Tracts in the Brain Tip: Medicare uses the term, “remote physiologic monitoring” in their coding and billing language. Reduced risk of illnesses for patients and health care workers.Better preventative management for chronic conditions.Better health outcomes for patients in rural areas.Shorter hospital stays if the patient can be discharged with a remote monitoring device to use at home.But there are many ways that remote patient monitoring can help with chronic conditions, pregnancy complications, and short-term illness. This depends on their condition, Internet capabilities, or personal preferences and abilities. Some patients will need in-person testing, diagnostics, or monitoring. Talk to your patients about the benefits of remote patient monitoring The ability to monitor and prevent serious complications in remote locations.A growing awareness of telehealth for providers and patients.More providers are implementing remote patient monitoring for several reasons, including: Specialized monitors for dementia and Parkinson’s diseaseĪs the popularity and convenience of telehealth grows, so does remote patient monitoring.Other conditions require more complicated devices that will require patient training, including: Many of the devices that patients will use may be familiar to them, including: There are many symptoms and conditions that can be tracked through remote patient monitoring, including: It can also prevent health complications in patients who aren’t able to easily travel. Remote patient monitoring pairs well with telehealth when patients need to be monitored for certain health conditions. How to use remote patient monitoring with telehealth
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