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HP: 3.3 Pain > 3.3.3 Managing and controlling pain > Flashcards

3.3.3 Managing and controlling pain Flashcards

1
Q

Managing and controlling pain

What is the most effective method to treat PLP?

A

Mirror therapy/treatment (MT).

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2
Q

Managing and controlling pain

What are the two main possibilities to manage pain?

A
  • Medication
  • Surgery
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3
Q

Managing and controlling pain

What are some examples of physical methods to manage pain?

A
  • Massage
  • Applying heat
  • Transcutaneous electrical nerve stimulation (TENS)
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4
Q

Managing and controlling pain

How can surgery be done to eliminate pain?

A

By severing nerves either at the periphery or in the central nervous system (spine and brain).

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5
Q

Implanted pain control systems

Implanted pain control systems

A

Involve inserting devices under your skin or elsewhere in your body.

These devices use medicine, electric current, heat or chemical to numb/block pain.

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6
Q

Implanted pain control systems

Intrathecal drug delivery

A

Sends medicine to the area of your pain.

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7
Q

Implanted pain control systems

Electrical nerve stimulation

A

Uses electric current to interrupt pain signals.

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8
Q

Implanted pain control systems

Nerve ablation

A

Destroys or removes the nerves that are sending pain signals.

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9
Q

Implanted pain control systems

Chemical sympathectomy

A

Uses chemicals to destroy nerves.

This treatment may be used for a type of chronic pain called complex regional pain syndrome, which affects the nervous system.

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10
Q

Medication

Common medications used to relieve pain

A

OTC (over-the-counter pills):
* Aspirin.
* Paracetamol/panadol/tylenol/advil.
* NSAIDS: Non-steroid anti-inflammatory drugs.

Opiods = codeine, morphine.

Implantable drug pumps.

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11
Q

Medication

Analgesics

A

Medicines used to relieve pain, are often called painkillers.

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12
Q

Medication

Non-steroidal anti-inflammatory drugs (NSAIDs)

A

A type of analgesic that reduces pain by reducing the production of the hormone-like substances that cause pain, prostaglandins.

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13
Q

Medication

Opiods

A

A type of analgesic which works by attaching to opiod receptors in the brain. These cells then release signals that reduce perception of pain and increase feelings of pleasure.

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14
Q

Medication

Prostaglandins

A

Hormone-like substances that cause pain.

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15
Q

Surgery

Strengths of surgery for pain

A
  • Immediate relief by going to the source of the problem
  • Done under doctor’s supervision
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16
Q

Surgery

Criticisms of surgery for pain

A
  • Invasive
  • Expensive
  • Time-consuming
  • Doesn’t always work
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17
Q

Acupuncture

Acupuncture

A

An ancient Asian method that can be used for a wide range of pain and involves inserting fine needles/pins into the skin at specific points and leaving them there for 10-30 minutes.

Normally several sessions are carried out and it’s believed this induces the release of endorphins into the body.

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18
Q

Acupuncture

Criticisms and strengths of acupuncture to treat pain

A

Could just have a placebo effect, however, there are no dangerous side effects and complications are very rare so it’s often worth a try.

19
Q

Acupuncture

Endorphins

A

The body’s natural pain-killing chemical.

20
Q

TENS

Transcutaneous Electrical Nerve Stimulation (TENS)

A

Method of pain relief involving a mild electrical current that sends impulses through the body.

The small, battery-operated device has leads connected to sticky ‘electrode’ pads, the impulses in sends out can reduce pain signals passing along nerves in the body and help with relxation.

21
Q

TENS

Strengths of TENS to treat pain

A
  • Fits with gate theory (sensations close the gate to pain).
  • Suitable for many patients since it’s non-invasive.
22
Q

TENS

Criticisms of TENS to treat pain

A
  • Not known how heat works in reducing pain.
  • Not suitable for all patients due to electrical current (for example, those with metal implants).
23
Q

Psychological treatments

What are some psychological techniques for managing pain?

A
  • Relaxation
  • Biofeedback
  • Hypnosis
  • Cognitive coping skills
  • Operant technqiues
  • Mental imaging
  • Self-efficacy
  • Counselling
24
Q

Psychological treatments

Strengths of hypnosis

A
  • Those who can be hypnotised easily and deeply seem to gain more pain relief.
  • Can be seen as a form of relaxation.
25
Q

Psychological treatments

Criticisms of hypnosis

A

Some are less susceptible to being hypnotised.

It produces a high degree of analgesia in only a minority of individuals.

26
Q

Cognitive redefinition

Cognitive redefinition

A

When the person substitutes threatening or negative thoughts about their pain with more rational/positive thoughts.

This is helped by learning clear info that helps them to think rationally about their pain.

This doesn’t remove pain, but helps patients to manage it.

27
Q

Cognitive redefinition

What are the 2 main kinds of self-statements for controlling pain?

A
  • Coping statements
  • Reinterpretative statements
28
Q

Cognitive redefinition

Coping statements

A

Emphasise the person’s ability to tolerate the pain, by saying to themselves, “it hurts, but you’re in control,” or “be brave- you can take it.”

29
Q

Cognitive redefinition

Reinterpretative statements

A

Designed to negate unpleasant aspects of the pain, as when people think, “it is not so bad,” “it’s not the worst thing that could happen,” or “it hurt’s but think of the benefits of this experience.”

30
Q

Cognitive redefinition

What type of pain does redefinition appear to be more effective with?

A

Strong/severe pain.

31
Q

Cognitive redefinition

Strengths of cognitive redefinition to manage pain

A
  • No negative side effects.
  • Positive self-statements are proven to be helpful.
32
Q

Cognitive redefinition

Criticisms of cognitive redefinition to manage pain

A
  • Ineffective when fears are rational or based on past experiences.
33
Q

Attention diversion/distraction

Attention diversion

A

The technique of focusing on a non-painful stimulus in the immediate environment in order to divert our attention from discomfort.

34
Q

Attention diversion/distraction

What type of pain does attention diversion appear to be more effective with?

A

Mild or moderate pain.
(McCaul and Malott, 1984)

35
Q

Attention diversion/distraction

Strengths of attention diversion to manage pain

A
  • Inexpensive, self-administered, effective.
  • No negative side effects.
  • Significantly reduces perceived pain and increases quality of life (Holden, 2013).
36
Q

Attention diversion/distraction

Criticisms of attention diversion to manage pain

A
  • Requires full belief in the power of distraction- patients must be able to focus their attention on something else.
37
Q

Non-pain imagery

Non-pain imagery

A

Involves creating pleasant, relaxing images in your mind, such as places you have been or would like to go, e.g. the beach.

This helps to ‘block out’ the pain.

38
Q

Non-pain imagery

Imagery

A

Used to reduce stress that can cause muscle tension.

Focused daydream that uses all your sense, can relieve tense muscles which may be adding to painful experience.

39
Q

Non-pain imagery

Strengths of non-pain imagery to manage pain

A
  • No negative side effects.
  • Patients have control over pain management.
  • Can be used whenever/wherever needed - inexpensive etc.
40
Q

Non-pain imagery

Criticisms of non-pain imagery to manage pain

A
  • Less useful for long periods since it can be hard to maintain visualisation.
  • Not everyone is able to visualise things (aphantasia).
41
Q

Morley, Shapiro and Biggs (2004)

What did their training include?

A
  • Basic attention management
  • Attention diversion
  • Discussion on dealing with pain
  • Pain coping strategies
  • Imagery and mindfulness
  • How to break vicious circle of pain
  • Pain coping strategies
42
Q

Morley, Shapiro and Biggs (2004)

How did patients benefit from the training?

A
  • More skills were developed to deal with pain
  • Altered attitude to pain
  • Improved sleep
  • Stress reduction
43
Q

Issues and debates

What approach do biological treatments take?

A

A nomothetic approach.

Paracetamol is often prescribed for pain, depsite researching showing it’s ineffective for many, individuals experience different side effects also.

HP: 3.3 Pain (3 decks)

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