8.3.1 Flashcards
Functions of Pain
Pain is subjective, with sensory and affective components. Those who view pain as a threat to health tend to rate its affective intensity higher than those who believe it’s due to something benign, like over-exercising.
Pain’s Function
Pain’s main function is to prevent further injury. Doctors use pain as a clue for diagnosis.
Acute Pain Definition
Acute pain is sudden, sharp pain lasting less than six months (ICD-11).
Chronic Pain Definition
Chronic pain usually lasts more than six months and can cause anxiety, exhaustion, sleep problems, and interfere with normal life.
Phantom Limb Pain
Phantom limb pain affects 80% of people who lose a limb and is more common in women. It may be explained by mixed signals, brain adjustments, or damaged nerve endings.
Phantom Limb Pain Description
Phantom limb pain can be described as ‘shooting,’ ‘burning,’ or ‘cramping’ and is considered a chronic condition, either recurrent or intractable.
Mirror Treatment Overview
Mirror treatment uses a mirror to create the illusion of an amputated limb, helping patients feel the phantom limb by moving the opposing limb in front of the mirror.
Mirror Treatment Mechanism
Mirror treatment works by establishing new neural connections in the brain, helping the patient ‘feel’ the phantom limb again, easing pain and breaking the negative feedback loop.
Ramachandran’s Contribution (1995)
Ramachandran et al. (1995) showed that mirror treatment helps break the feedback loop of phantom limb pain and establishes new neural connections.
MacLachlan et al. (2004) Study Aim
The aim of MacLachlan et al. (2004) was to report on the effects of mirror treatment on a person with a lower limb amputation.
MacLachlan et al. (2004) Methodology
MacLachlan et al. (2004) used a case study of a 32-year-old man with leg amputation who had previously used painkillers and a TENS machine, but found no relief.
MacLachlan et al. (2004) Results
After using mirror treatment, the patient’s phantom limb pain reduced to 0 on a 0-10 scale, and he felt more control over his phantom limb.
MacLachlan et al. (2004) Conclusion
MacLachlan et al. (2004) concluded that mirror treatment is effective for phantom limb pain and allows patients to manage their pain without medication.
Specificity Theory of Pain
Specificity theory posits that pain has a sensory system specifically dedicated to it, with more intense pain occurring as the pain pathway is used more.
Gate Control Theory Overview
Gate control theory (Melzack & Wall, 1965) suggests that small, slow fibres carry pain signals to the spinal cord, passing through a ‘gating mechanism’ to transmit pain signals to the brain.
Gate Control Theory and T-cells
In gate control theory, T-cells (transmission cells) activate to transmit the pain signal, with the gate’s openness depending on various factors.
Gate Control Theory: Activity in Pain Fibres
According to gate control theory, the gate opens wider with more activity in slow pain fibres, leading to more intense pain.
Gate Control Theory: Peripheral Fibres
Other peripheral fibres carry harmless stimuli and help close the gate, reducing the intensity of pain.
Gate Control Theory: Brain Influence
Messages from the brain to the spinal cord can influence the gate’s openness. Emotions such as anxiety or boredom can open it, while happiness or distraction can close it.
MacLachlan et al.’s Case Study in Daily Life
MacLachlan et al.’s (2004) case study shows how mirror treatment can be used by practitioners or at home to manage phantom limb pain.
Specificity Theory Validity
Specificity theory has been discredited, as there is no physical evidence of a gating mechanism in the spinal cord, suggesting other mechanisms may be involved.
Placebo Effect in Mirror Treatment
MacLachlan et al.’s study results might have been influenced by the placebo effect, as receiving treatment and clinician attention could have contributed to the improvement.
Case Study Insights
MacLachlan et al.’s case study provides a detailed insight into the patient’s background and treatment effectiveness compared to other treatments.
Generalisability of MacLachlan et al. Study
The findings of MacLachlan et al.’s study cannot be easily generalized because pain is subjective, and individual experiences with mirror treatment vary.
Nature vs. Nurture in Pain Perception
Gate control theory of pain focuses on the ‘nature’ side, emphasizing biological mechanisms, but neglects environmental and psychological factors that also influence pain.
Reductionism vs. Holism in Pain Theories
Gate control theory and MacLachlan et al.’s research take a holistic view, recognizing both physical and psychological aspects of pain, though they don’t account for individual differences.
Gate Control Theory: Emotional Impact
Emotions, such as anxiety, can widen the pain gate, while positive emotions like happiness can help close it, affecting pain perception.
Acute Pain Characteristics
Acute pain is intense and occurs suddenly, typically lasting less than six months. It acts as a warning signal to prevent further injury.
Chronic Pain Impact on Life
Chronic pain can severely impact an individual’s life by causing anxiety, depression, and sleep disturbances, making it harder to lead a normal life.
Phantom Limb Phenomenon in Women
Phantom limb pain is more common in women than men, affecting 80% of those who have had a limb amputated.
Psychological Factors in Pain Perception
Social, genetic, and cognitive factors, including psychological factors, significantly influence how individuals experience pain.
Chronic Pain and Sleep Disturbance
Chronic pain is known to disrupt sleep, leading to additional mental and physical exhaustion for the sufferer.
The Role of Social Context in Pain Perception
Pain perception is shaped by social factors such as cultural norms, social support, and exposure to others’ pain experiences.
Mirror Treatment and Neurological Reprogramming
Mirror treatment is believed to help ‘reprogram’ the brain to alleviate phantom limb pain by making it feel as if the limb is still there.
Phantom Limb Pain Treatment Challenges
Despite available treatments, phantom limb pain remains difficult to treat and often persists for long periods following limb loss.
Pain Management Through Distraction
Distraction techniques, as proposed by gate control theory, can help manage pain by closing the pain gate through focus on other stimuli.
Transcutaneous Nerve Electrical Stimulation (TENS) Machine,” “The TENS machine was used in MacLachlan et al.’s case study for managing phantom limb pain, but it worsened the pain before mirror treatment was applied.
Placebo Effect in Pain Treatment
Placebo effects can play a significant role in pain treatment, as the expectation of relief or attention from clinicians may contribute to perceived improvements.
Gate Control Theory: Physiological vs. Psychological Factors
While gate control theory incorporates both physiological and psychological factors in pain processing, it does not fully account for all the complexities of pain experiences.
Pain as a Diagnostic Clue
Pain provides crucial diagnostic information for doctors to help identify the underlying causes of health issues.
Long-Term Effects of Chronic Pain,” “Chronic pain can lead to long-term issues, such as dependence on pain medications, social isolation, and a reduced quality of life.
Acute vs Chronic Pain in Diagnosis
Acute pain typically signals immediate injury, while chronic pain may point to ongoing or unresolved health issues, making it critical in diagnosis and treatment planning.
