Chapter 10 - Pain And Its Perception

Question 1

Hows does pain impact government?

Answer 1

Costs i health care utilization are approximately $10 billion annually

• over $21 percent billion annually spent on OTC MEDS

Question 2

What are the 2 types of pain?

Answer 2

Acute - caused by soft tissue damage
- infection
- inflammation
Short term

Chronic -

• Linked with long term illness or disease
• may have no apparent cause
• can trigger other issue
• difficult to asses and diagnose

Question 3

What are the 3 types of chronic pain?

Answer 3

CHRONIC BENIGN - 6+ month, intractable to treatment (lower back pain)

RECURRENT ACUTE PAIN - series of intermittent episodes (migraine, tmj)

CHRONIC PROGRESSIVE - 6+ month, increasing severity (rheumatoid arthritis)

Question 4

Why is pain significant?

Answer 4

Provides us with low level feedback about our systems bodily functioning
- we use this feedback unconsciously to make minor adjustments (shifting position, rolling over)

Question 5

What are 3 factors that influence symptoms of pain?

Answer 5

Culture - chinese students have lower tolerance

• some cultures report pain sooner and more intensely
• linked to cultural norms

GENDER - women have more sensitivity

• menstruated cycle is an indirect contributor
• linked to differences in emotional processing of pain (women respond to threatening stimuli with greater negative effect, which amplifys the pain)
• demonstrates biopsychosoxial nature of pain

COPING STYLES 
- catastrophizing heightens pain (ruminate on the pain and feel helpless)
Greater post surgical
More intense labour
Longer post injury work absence

Resilience and lower emotion lowers pain

Question 6

How is pain measured?

Answer 6

Verbal reports

Pain behaviour
- observable behaviours that derive from pain

Viewers as a complex BPS event

Question 7

What are the 4 observal criteria of pain behaviour?

Answer 7

1) facial and audible expressions of distress
2) distortions in posture and gait
3) negative affect
4) avoidance of activity

Question 8

What are three kinds of physiological pain perception?

Answer 8

NOCIOCEPTION - pain perception that trsults from mechanical damage to body tissue

THERMAL DAMAGE - pain due to temperature exposure

POLYMODAL NOCIEPTON - pain that triggers chemical reaction from tissue damage

Question 9

How does NOCIOCEPTION WORK?

Answer 9

1. Refers to the system that carries signals of damage and pain to the brain
2. Nociceptive neurons have cell bodies in the DORSAL ROOT GANGLIA
3. Can detect thermal mechanical and chemical stimuli

4.

Question 10

What are the theories of pain?

Answer 10

TRADITIONAL MODEL - suggested pain resulted from transmission of pain signals to the brain. Degree of pain was dictated by tissue damage

GATE CONTROL THEORY

Question 11

What is the gate control theory?

Answer 11

• proposed that psychological factors contributed to pain experience
• there is a neural PAIN GATE that opens and closes to modulate pain signals to the brain

Question 12

How is the pain gate opened and closed?

Answer 12

• in spinal column by the dorsal horn
• A-delta and C fibers open
• A-beta close

Physical
Cognitive
Emotional factors

Question 13

What is the prevelance of chronic pain?

Answer 13

1. 5 million Canadians (1 in 10)
   - higher over 65
   - higher Im women (back pain, migraine, arthritis)
   - being unmarried, low income, rural area have higher chronic pain