250. Acute/Chronic Pain

Question 1

Acute v Chronic Pain

Nociceptive v Neuropathic Pain

Answer 1

Acute: <3month
Chronic: >3month

Nociceptive: tissue injury/damage
Neuropathic: nervous system damage

Question 2

Plasticity

Chronic Pain’s effect on plasticity and descending inhibitory pathway

Answer 2

Plasticity: nervous system’s ability to reorganize itself and adjust its fx/activity in response to new situations/changes in environment

Chronic pain: plasticity is maladaptive - causes hypersensitized nerves perpetuating chronic pain; also chronic pain pts lose fx of descending inhibitory modulation of pain

Question 3

Definition of Sensitization

Answer 3

Hyperalgesia (increased sensitivity) due to damaged tissues releasing substances to augment nociceptive fibers

Persistent state of high reactivity
Lowers pain threshold
Maintains pain even after initial injury heals

Question 4

Peripheral Sensitization Effects

Answer 4

Allodynia and Hyperalgesia

Question 5

Central Sensitization Effects

Answer 5

Allodynia and Hyperalgesia
Loss of descending inhibition
heightened sensitivity across ALL senses
increased anxiety/sick behaviors

Question 6

Acute Pain definition

Answer 6

Due to injury trauma
Signal our body needs healing
EXPECTED duration of time
Pain ceases when injury healed

Question 7

Chronic Pain definition

Answer 7

pain past time of healing
Pt develop guarding, fear of movement, generalizing of pain, sick role, change in family/community roles
Structural changes in PNS/Brain

Question 8

Triad of Chronic Pain

Answer 8

Psychological Vicious Cycle of: Pain - Depression/Anxiety - Sleep Disturbances - More Pain, all causing more functional impairment

Physical Cycle: Pain - Activity Avoidance - Deconditioning - Pain with less activity - repeat

Question 9

Tx Acute Pain

Answer 9

Rest, Pharm, Non-Pharm, Surgical Options

Biomedical Tx Model: treat damage = resolve pain

Question 10

Tx Chronic Pain

Answer 10

Interdisciplinary Tx Model: Team of professionals addressing both physical and emotional components of chronic disease states - coping with sx and improving fx

Goal to increase physical activity (INCREASE FX DECREASE PAIN),
Meds: for pain, for depression/anxiety, for sleep
PT/OT/Biofeedback
Vocational tx for return to work
GOAL TO MINIMIZE PAIN (not resolve it)