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HP: 3.3 Pain > 3.3.1 Types and theories of pain > Flashcards

3.3.1 Types and theories of pain Flashcards

1
Q

Definitions of pain

Pain

A

A subjective unpleasant experience (both sensory of physical and emotional) which can be associated with actual or threatened tissue damage/irritation.

Pain can exist without injury and nearly every person experiences pain.

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2
Q

Definitions of pain

Measures of pain

A

A variety of methods and techniques to assess the type, levels and qualities of pain experienced by patients.

These methods can be self-reports, physiological tests or even behavioural observations.

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3
Q

Definitions of pain

Controlling pain

A

Various techniques used by medical practitioners to help patients reduce or eliminate the pain they experience.

These techniques include medicines, such as morphine or physical methods such as massages or even psychological methods such as hypnosis.

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4
Q

Types of pain

Chronic pain

A

Pain that lasts a relatively long time and is resistant to treatment.

Likely to be the result of long-term behavioural factors such as physical extertion, or due to chronic illnesses such as cancer.

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5
Q

Types of pain

Acute pain

A

Can be severe but comes on quickly and lasts and lasts a relatively short period of time.

Acute pain is usually in a very specific location and has an identifiable source.

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6
Q

Types of pain

Phantom limb pain

A

Common problem for people who lost a limb.

Even though the arm or leg is no longer there, PLP occurs when the individual still experiences pain as coming from that area.

It is very difficult to treat.

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7
Q

Factors affecting pain

What factors can affect someone’s experience of pain? How?

A
  • Learning: if migraine sufferes are shown words associated with pain, it increases their anxiety and sense of pain (Jamner & Turksey, 1987).
  • Anxiety: women with pelvic pain appear to show a correlation between anxiety and pain strength (McGowan et al., 1988).
  • Gender: women find post-surgical pain more intense, whilst men are more disturbed by low levels of pain that last several days (Morin et al., 2000).
  • Cognition: whether we feel in control of pain, the way we think about it etc. - this forms the basis for cognitive therapies.
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8
Q

Chronic pain

Common characteristics of chronic pain

A
  • Symptoms last longer than 6 months
  • Few objective medical findings
  • Medication abuse
  • Difficulty sleeping
  • Depression
  • Manipulative behaviour
  • Somatic (bodily) preoccupation
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9
Q

Theories of pain - Specificity theory (Von Frey, 1895)

What kind of explanation is this?

A

A biological theory.

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10
Q

Theories of pain - Specificity theory (Von Frey, 1895)

What 4 types of sensory receptors does the specificity theory involve?

A
  • Heat
  • Cold
  • Touch
  • Pain
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11
Q

Theories of pain - Specificity theory (Von Frey, 1895)

According to this theory, how many types fo sensory receptors does a nerve respond to?

A

Only 1 type.

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12
Q

Theories of pain - Specificity theory (Von Frey, 1895)

What does Von Frey argue we have a seperate system for?

A

Processing pain.

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13
Q

Theories of pain - Specificity theory (Von Frey, 1895)

According to this theory, how do we process pain?

A
  1. Specialised pain receptors respond to stimuli and via nerve impulses, send signals to the brain.
  2. The brain then processes the signal as the sensation of pain, and responds with a motor response to try and stop the painful sensation.
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14
Q

Theories of pain - Specificity theory (Von Frey, 1895)

Example of this theory of pain in action

A

Touching something hot, like a stove top, induces pain the the hand, which would cause nerve impulses in the hand to send a signal to the brain. The brain would then send signals back to the muscles in the hand, telling it to move away from the source of pain.

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15
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

What kind of explanation is this?

A

A physiological theory.

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16
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

What is the theory briefly?

A

Non-painful input closes the “gates” to painful input, which prevents pain sensations from travelling to the central nervouse system.

Therefore, stimulation by non-noxious input is able to suppress pain.

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17
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

Where is the gating mechanism located?

A

Occurs in the dorsal horn of the spinal cord.

18
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

What types of fibres carry info to the spinal cord?

A

Small nerve fibres (pain fibres) and large nerve fibres (for touch, pressure etc.).

19
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

When are the gates closed?

A

When there is more large fibre activity compared to small fibre activity, people experience less pain (the gates are closed).

20
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

When are the gates open?

A

When there is more small fibre activity, pain signals can be sent to the brain so that pain can be perceived (the gates are open).

21
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

What reaction does this theory explain?

A

**Why we tend to rub injuries after they happen.
**
For example, if you bang your elbow you may rub where it hurts for a few minutes. This increase of normal touch sensation (large fibres) inhibits the activity of pain fibres (small fibres) so pain perception is reduced.

22
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

What factors can open the gate?

A
  • Physical factors = bodily injury.
  • Emotional factors = anxiety and depression.
  • Behavioural factors = attending to the injury and concentrating on the pain.
23
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

What factors can close the gate?

A
  • Physical pain = analgesic remedies, e.g. aspirin.
  • Emotional pain = being in a ‘good’ mood.
  • Behavioural factors = concentrating on things other than the injury.
24
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

Strengths of GCT

A
  • Most influential pain model so far.
  • Experiments with animals have shown stimulating certain areas of the brain can produce a numbing effect on animals and humans.
25
Q

Theories of pain - Gate control theory (GCT) (Melzack and Wall, 1965)

Criticisms of GCT

A
  • Still assumes simple stimulus-response model of pain.
  • No physical evidence of a ‘gate’.
  • Still considers psychological and physical processes as separate.
26
Q

Phantom limb pain (PLP)

What are 7 features of PLP according to Melzack (1992)?

A
  1. Limb feels real,
  2. Arm hangs at side when resting.
  3. Limb may get stuck in awkward position.
  4. Patients see artificial limbs as real body parts.
  5. Limbs give impression of pressure/pain.
  6. Limb still feels as if it belongs to the patient.
  7. Can experience cycling legs.
27
Q

Phantom limb pain (PLP)

Neuromas

A

Cut nerve endings.

28
Q

MacLachlan et al. (2004)

Participant

A

32 year-old male named Alan suffering from PLP.

29
Q

MacLachlan et al. (2004)

Method

A

Case study.

30
Q

MacLachlan et al. (2004)

What limb was Alan missing?

When did he become aware it was gone?

A

He had life-saving surgery to remove his leg at the hip.

He was unwell afterwards, and become fully aware of the amputation 5 weeks laters.

31
Q

MacLachlan et al. (2004)

When did Alan start complaining of PLP?

What was his experience of it?

A

2 days later he began to complain of PLP, as well as pain at the amputation point.

At the beginning of the day. it was mild pain wiht ‘pins and needles’ in his toes. By evening, the pain was severe.

He felt the leg was shorter than his other one, in a cast, facing backwards with toes pointing downwards.

32
Q

MacLachlan et al. (2004)

What treatment was he given prior to the study?

A

Painkillers and a course of Transcutaneous Electrical Nerve Stimulation (TENS), however, pain only worsened.

33
Q

MacLachlan et al. (2004)

What treatment was he given during the case study?

For how long?

A

Mirror treatment (MT) for 3 weeks.

34
Q

MacLachlan et al. (2004)

Mirror treatment (MT)

A

A mirror is used to create a reflective illusion of an affected limb, to trick the brain into thinking movement has occured without pain, or to create positive visual feedback of a limb movement. It involves placing the affected limb behind a mirror.

35
Q

MacLachlan et al. (2004)

Results

A
  • PLP reduced to 0 on a 0-10 scale.
  • He felt more control over the phantom limb than prior to the MT.
  • Stump pain was reduced to 1.
36
Q

MacLachlan et al. (2004)

Conclusion

A
  • Mirror treatment is effective for phantom limb pain.
  • It gives patients more control over their pain, since they can avoid taking medication.
37
Q

MacLachlan et al. (2004)

Strengths

A
  • RWA = MT could be used in hospitals or in patients’ own homes.
  • Case study = detailed, qualitative data was collected.
38
Q

MacLachlan et al. (2004)

Criticisms

A
  • Low validity = results could be ‘placebo effect’ since just receiving treatment can have a positive effect, or researchers’ attention may have contributed to results.
  • Ungeneralisable = case study of one individual cannot be generalised to others, since pain experiences are subjective and diverse.
39
Q

Issues and debates

How do the GCT theory and MacLachlan’s study both demonstrate reductionism vs holism?

A

They both take a holistic approach to pain, accounting for physical and psychological factors.

However, neither account for individual differences in pain experience.

40
Q

Issues and debates

How does the GCT show nature vs nurture?

A

Focuses on the nature side of the debate.

However, this ignores environmental (nurture) factors affecting pain perception, such as hearing others in pain or harsh lighting. Also ignores other treatments, like psychological ones.

HP: 3.3 Pain (3 decks)

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