SUMMARY BACKGROUND AND OBJECTIVES:Along time, physical therapy has played an important role in the treatment of painful patients. Several neurophysiological mechanisms have been proposed to explain pain modulation via physical and cognitive behavioral approaches; however they have to be further explored by the physical therapist. This study aimed at reviewing major action mechanisms and effects of physical therapy techniques to manage pain. CONTENTS: There are studies on the action mechanisms and effects of physical therapy during pain processing stages in the nervous system. To organize information, mechanisms and theories were grouped in peripheral and central stations. Effects, however, were grouped in motor, sympathetic and hormonal systems, psychophysiological factors and placebo. CONCLUSION: Several mechanisms and effects may be influenced by physical therapy physical and cognitive behavioral techniques, thus contributing to the treatment of painful patients and helping the choice of techniques based on identified clinical mechanisms. Keywords: Pain, Pain perception, Physical therapy modalities. RESUMO JUSTIFICATIVA E OBJETIVOS:A fisioterapia vem ao longo dos anos mostrando um importante papel no tratamento de pacientes com dor. Diversos mecanismos neurofisiológicos já foram propostos para explicar a modulação da dor por meio de abordagens físicas e cognitivas comportamentais, porém necessitam ser mais bem explorados pelo fisioterapeuta. O objetivo deste estudo foi revisar os principais mecanismos de ação e efeitos das técnicas fisioterapêuticas para o tratamento da dor. CONTEÚDO: Estudos refletem sobre os mecanismos de ação e efeitos da fisioterapia durante as etapas de processamento da dor no sistema nervoso. Para organizar as informações, os mecanismos e teorias foram agrupados em estações periféricas e centrais. Já os efeitos foram agrupados nos sistemas motor, simpático e hormonal, efeitos psicofisiológicos e placebo. CONCLUSÃO: Diversos mecanismos e efeitos podem ser influenciados pelas técnicas físicas e cognitivas comportamentais da fisioterapia, contribuindo para o tratamento de pacientes com dor e facilitando a escolha das técnicas com base nos mecanismos clínicos identificados. Descritores: Dor, Modalidades de fisioterapia, Percepção da dor.

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Chronic neuropathic pain emerges as a challenge in the treatment of leprosy patients after multidrug therapy discharge. The aim of this study was to determine the quality of life and its repercussions in leprosy patients with chronic pain. We studied male and female patients with chronic neuropathic pain in the last year. Neuropathic pain was confirmed using Douleur Neuropathique en 4 (DN4) and its intensity evaluated by visual analogue scale (VAS). A general questionnaire was applied to evaluate quality of life (WHOQOL-bref). Statistical analyses were composed by descriptive and central tendency. Spearman correlation was used to identify the relation between pain intensity, quality of life domains, and facets. Multiple linear regressions were performed to verify the influence of pain intensity on each facet. Neuropathic pain patients scored worst in physical and environment domains. The low facets were related to pain and discomfort, thinking and concentration, sexual activity, and recreation opportunities. Pain intensity has a high negative influence on psychological domain and recreation opportunities. These findings should contribute to the development of rehabilitation programs considering patients needs to improve their quality of life and true social reintegration.

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