Chapter 12: pain and pain management Flashcards
What is Pain
unpleasant sensory or emotional experience associated with actual or potential tissue damage
Clinical pain
when people need to seek treatment
Acute pain
usually associated with recent ongoing tissue damage (e.g. an injury - short term
- Pain after surgery impairs endocrine and immune functioning (impairs wound healing)
What are the evolutionary/adaptive functions of acute pain?
- Survival
- Information
- Warn of potential serious injury
- Promote learning to avoid same situations later
- Limit physical activity and promotes rest
What is Chronic Pain?
Persists beyond the normal expected healing period or is otherwise persistent over time (at least 3-6 months)
- Patients perception of chronic pain is different than acute pain. As you don’t see an end to pain.
What occurs during the Transition from acute to chronic pain?
- Increase in disability
- Loss of self-efficacy
- Fear of activities causing more pain
What are some Rating Scales for Pain
- Self-report rating (rate from 1-10 how bad your pain is)
- Visual Analog scale (move a measure along a scale - more precise)
What is Observational pain rating
- May be needed if you can’t communicate with the patient
- Use ongoing vs transient system to determine if the patient is in pain
McGill pain Questionnaire
Gives people words to vocalize their pain
- Circle one word in each group
- Circle 3 words in group 1-10
- Circle 2 words in group 11-15
- Pick one word from group 16
- Pick one from group 12-20
- These seven words will be used when talking to your doctor
Treatment of Pain a Few centuries ago
- Poked pain away with a “vigorous” twig, and twig absorbs the pain
- Buried twig to prevent others from getting pain
Treatment of Pain in the 19th Century
Medicine was laced with opium or alcohol to relieve pain and perform surgeries
Treatment of Pain Today
- Two primary sources of pain management
- Surgical and chemical
- Chemical treatment is most frequently used today
When does Surgical Treatment of Pain take place/ what methods are used?
- Typically only performed when chemical methods have failed
- Neuroablation (rarely used in Canada - has side effects and rarely works long term)
- More effective treatments include Synovectomy, Spinal Fusion
What is Neuroablation
surgery to remove part of the PNS or spinal cord (remove part of the nervous system causing pain - rarely used in Canada as it can affect your life in other ways)
- Has side effects and rarely works long term
What is Synovectomy
inflamed membranes are removed in arthritic joints
What is Spinal Fusion
joins two or more adjacent vertebrae to treat severe back pain (fuse two vertebrae - used in Canada but not other developed countries)
What are some Chemical Treatments of Pain?
- Analgesics (opioid, non-opioid, non steroidal anti-inflammatory drugs), Anesthetics.
Medications are given as
1. As a prescribed schedule
2. Pro re nata (PRN) - “as needed” (becoming the standard)