3 Pain Neuroscience Flashcards
research demonstrates the direct connection between ___ and___
Persistent/chronic pain and neuroplasticity
susceptibility to pain and development of persistent/chronic pain is determined by interaction between:
- genetic predisposition
- environmental factors (epigenetic)
- lifestyle factors (epigenetic)
- physiologic response
what epigenetic factors are most modifiable? least modifiable?
most: habits (e.g. smoke/alcohol), physical activity, and diet
least: (early-) life stress
T/F: a musculoskeletal injury such as an ankle sprain will result in pain receptors conveying the afferent pain signal to your brain
FALSE
no such thing as pain pathways
what would happen if a speeding truck was headed straight for you immediately after you severely sprained your ankle while stepping off a curve?
brain tells you to move!!
T/F: pain only occurs if there is tissue damage
FALSE
There were a bunch of people who had disc problems and no pain. There is only a 50% correlation between knee pain complaints and findings of arthritic/degenerative changes on radiograph
what should you do before you consider potentially harmful interventions such as surgery?
physical findings corroborate/support imaging findings
Can individuals suffer from significant pain, and yet no tissue damage occurred or is healed and no disease process can be identified/
YES
the work boot example
what is an example of somatisation or somatic symptom disorder
work boot example, where physical symptoms occur that can’t be explained by tissue damage
T/F: the CNS/brain determines when you will experience pain
TRUE
The ___ can amplify the signal, turn it down, or tell the nerves how much of a signal to send up
brain
___ can be set by the brain, and/or by conditions right in the tissue. Even the structure of the nerves can and does change.
Nerve sensitivity
T/F: the resting level of a neuron can vary (it becomes more or less excitable)
TRUE
___ in the neuron axonal membrane control sensitiivity to depolariizatiion (sensitization of the PNS and/or CNS)
ion channels
normal function of nociception
3 in thru primary afferent
to dorsal horn neurons
3 out thru secondary afferent
modulation of nociception for incoming danger messages
3 in thru primary afferent
to dorsal horn neurons
5 out thru secondary afferent (happens in situations where there is potential for significant tissue damage)
modification of nociception for patient with peristent/chronic pain
ALLODYNIA
1 in thru primiary afferent
to dorsal horn neurons
5 our thru secondary efferent (can result in sensitization, producing way larger signal than expected)
T/F: for individuals with chronic pain, hormones/chemicals associated with stress can directly activate nociception pathways
TRUE
Basic stress or threat response is sympathetic nervous system mediated (fight or flight). This promotes stress hormone release of:
adrenaline/epinephrine AND cortisol
what hormone suppresses the immune system and its long term circulation can result in pro-inflammatory effects?
CORTISOL
nociception is the neuronal response to ___
intense stimuli
what type of pain arises from nociceptive afferent signals arising from tissue damage/irritation/deformation
nociceptive pain (acute)
does nociceptive pain have a mechanical and/or chemical component? if so, give examples.
BOTH
Mechanical - tissue deformation/damage
Chemical - inflammatory process, inflammatory cascade of cytokines
what is the most common nociceptive pain that is musculoskeletal system related
somatic
what type of pain is related to hollow organs and smooth muscle related (highly sensitive to distention/stretch, ischemia, and inflammation)
visceral nociceptive pain
what type of pain is reported by autonomic afferent fibers thru dual sensory innervation? what tracts do they come from?
visceral nociceptive from spinothalamic and spinoreticular tracts
what type of pain is vague and not well localized and is usually pressure like, deep squeezing, dull or diffuse, and often referred to more superficial locations on the body
visceral nocicecptive pain
what occurs when noxious stimulation of viscera triggers somatiic afferent input and the brain translates the input as pain occurring at a somatic site
REFERRED visceral pain
what is reported to the brain by the somatic afferent nervous system? what tract?
somatic nociceptive pain frmo spinothalamic tract
what type of pain results from noxious insults or injury of tissues such as skin, muscles, joints, tendons or bones
somatic nociceptiive
what type of pain is often sharp and well localized, and it aggravated by activity and relieved by rest
somatic nociceptive pain
what type of pain is initiated or caused by primary lesion or disease affecting the nervous system (signal transmission)
neuropathic pain - ACUTE and may develop into persistent/chronic condition
what type of pain ranges from deficits perceived as numbness and paratheia (tingling) to hypersenitivity (hyperalgesia or allodynia)
neuropathic paiin
what is an exaggerated reponse to a noxious stimuluss resultant from peripheral nervous system change (sensitization - often locally mediated by inflammatory chemicals)
hyperalgesia
what is the perception of pain from normally innocuous stimuli resultant from PNS and CNS changes (sensitization = neuroplastic changes)
allodynia
is facial pain a typical symptom of facial nerve neuropathy (Bells Palsy)?
NO. Facial does not do sensory. Trigeminal does sensory.
what type of pain are neuroplasticity based changes
“other” pain (persistent/chronic)
___ is the amplification of danger signaling in any part of the nervous system (PNS or CNS)
sensitizatioin
what is a proposed phyisological phenomenon where neuron plasticity is maladaptive, resulting in neuronal hyperexcitability/hypersensitivity to both noxious and non-nonxious stimuli
sensitization
neuron sensitization is associated with
- allodynia
- hyperalgeisa
- expansion of receptive field
- unusually prolonged pain after a painful stimulus has been removed
what is pain resulting from non-painful stimuluss
allodynia
what is excessive sensitivity to a normally painful stimulus
hyperalgesia
Cartesian Model of Pain
ALL PAIN results from injury. Increased pain means greater tissue damage
nociception and pain are synonymous
Gate Control Theory
nociceptive signals can be blocked or changed based on other signals
nociception and pain are synonymous
what is the processs by which info about noxious stimuli is conveyed by the brain and is the total sum of neural activity
nociception in neuromatrix theory
Neuromatrix theory
pain is a conscious experience that results from brain activity in response to a NOXIOUS stimuli and engages sensory, emotional and cognitive processes of the brain.
what are the 2 components of pain in relation to the neuromatrix theory
- sensory-discriminative (perceived intensity, location, and quality of pain)
- affective-emotional (perceived unpleasantness of painful event)
acute nociception is caused by
mechanical, temperature, or acid/chemical substance
inputs for neuromatrix theory
cognitive, emotion, and sensory (nociceptive input)
outputs for neuromatrix theory
pain, motor, stress, emotion
what is homeostatic neuroplasticity
learning and memory
(excitatory/inhibitory BALANCE)
what is maladaptive neuroplasticity
persistent pain, addiction
(excitatory/inhibitory IMBALANCE)
what is is any physiologic change in neuron structure or function that is observed either directly from measures of individual neurons or inferred from measures taken across populations of neurons that correlate with behavioral change.
neuroplasticity
what is the brain’s ability to reorganize itself by forming new
neural connections throughout life. ____
allows the neurons (nerve cells) in the brain to
compensate for injury and disease and to adjust their
activities in response to new situations or to changes
in their environment.
neuroplasticity
where can neuroplasticity occur
peripherally or centrally with both afferent and efferent neurons
do nociceptive neurons have positive feedback loops
yes
how can neuroplasticity be used for emotional and cognitive areas
changing words and exercise based treatment
