Chapter 14: Managing Pain

Question 1

clinical pain

Answer 1

pain that requires some form of medical treatment

Question 2

acute pain

Answer 2

sharp, stinging pain that is short-lived and usually related to tissue damage

Question 3

recurrent pain

Answer 3

episodes of pain followed by relief for more than three months

Question 4

chronic pain

Answer 4

dull, burning pain that is long-lasting, either 6 months or longer

Question 5

hyperalgesia

Answer 5

a condition in which a chronic pain sufferer becomes more sensitive to pain over time

100’s of studies have concluded that hyperalgesia occurs as a normal adaptation during sickness. most kinds of internal pain are accompanied by increased sensitivity in neraby tissue

Question 6

physical measures of pain

Answer 6

EMG (electromyography) assesses the amount of muscle tension experienced by patients suffering from headaches or lower back pain.

Researchers have also recorded changes in heart rate, breathing rate, blood pressure, skin temperature, and skin conductance - all indicators of the autonomic arousal that may accompany pain

Question 7

behavioral measures of pain

Answer 7

Pain response preference questionnaire

has been used to assess the degree to which a range of potential pain-related reponses are desired from a spouse or partner

Question 8

self-report measures for pain

Answer 8

visual analog scale (with the 5 different facial expressions)

people locate the level of their pain at a point along a horizontal or vertical line that is anchored by two extremes: “no pain” and “worst pain.”

Question 9

free nerve endings

Answer 9

sensory receptors found throughout the body that respond to

temperature
pressure
painful stimuli

Question 10

nociceptor

Answer 10

a specialized neuron (pain receptors) that responds to painful stimuli

Question 11

fast nerve fibers

Answer 11

large, myelinated nerve fibers that transmit sharp, stinging pain

Question 12

slow nerve fibers

Answer 12

small, unmyelinated nerve fibers that carry dull, aching pain

Question 13

substantia gelatinosa

Answer 13

the dorsal region of the spinal cord

region where both fast and slow pain fibers synapse with sensory nerves on their way to the brain

Question 14

fast pain system

Answer 14

appears to serve only the skin and mucous membranes

Question 15

slow pain system

Answer 15

servers all other body tissues expect the brain itslef, which does not experience pain

Question 16

referred pain

Answer 16

pain felt in a part of the body other than its actual source

Question 17

substance P

Answer 17

a neurotransmitter secreted by pain fibers in the spinal cord that stimulates the transmission cells to send pain signals to the brain

Question 18

enkephalins (endogenous)

Answer 18

endogenous (naturally occurring) opioids found in nerve endings of cells in the brain and spinal cord that bind to opioid receptors

Question 19

periaqueductal gap (PAG) (midbrain)

Answer 19

a region of the midbrain that plays an important role in the perception of pain

electrical stimulation in this region activates a descending neural pathway that produces analgesia by “closing the pain gate”

Question 20

anterior cingulate cortex (ACC)

Answer 20

the front part of the cingulate cortex, which resembles a collar in surrounding the corpus callosum and plays a role in pain processing and many self-regulating functions

Question 21

endogenous opiate (peptides)

Answer 21

opiatelike substances naturally produced by the body

Question 22

stress-induced analgesia (SIA)

Answer 22

a stress-related increase in tolerance to pain, presumably mediated by the body’s endorphin system

Question 23

naloxone

Answer 23

an opioid antagonist that binds to opioid receptors in the body to block the effects of natural opiates and painkillers

it can treat narcotic overdoses in emergency situations

Question 24

gate control theory of pain

Answer 24

excitatory signals (pulses) tend to open the gate; inhibitory signals (minuses) tend to close the gate.

proposed the existence of neural structures in the spinal cord and brainstem that function like a gate, swinging open to increase the flow of transmission from nerve fibers or swinging shut to decrease the flow. with the gate open, signals arriving in the spinal cord stimulate sensory neurons called transmission cells, which, in turn, relay the signals upward to reach the brain and trigger pain. with the gate closed, signals are blocked from reaching the brain, and no pain is felt

Question 25

age and pain

Answer 25

pain is strongly associated with decreased physical capacity

older adults with pain, particularly those with pain in multiple locations, had weaker muscle strength, slower walking speed, and poorer overall function than those without pain

Question 26

gender and pain

Answer 26

men show pain less than women, but women experience pain more intensely and for longer than do men

Question 27

phantom limb pain

Answer 27

pain following amputation of a limb, false pain sensations that appear to originate in the missing limb

Question 28

socioeconomic status and stress

Answer 28

people of lower SES have greater levels of morbidity and mortality across many diseases when compared with those at higher SES levels. They also may experience more stressful life events.

the challenges associated with lower SES also make those who suffer chronic pain more vulnerable to the harmful effects of stress on health and physical functioning

Question 29

pain behaviors

Answer 29

actions that are a response to pain, such as taking drugs, grimacing, or taking time off from school or work

Question 30

opioid analgesics

Answer 30

formerly called narcotics, opioids are agonists (excitatory chemicals) that act on specific receptors in the spinal cord and brain to reduce either the intensity of pain messages or the brain’s response to pain messages

most powerful is morphine, but people build up tolerance to it very quickly and need steadily higher dosage for the same effects

Question 31

non-steroidal anti-inflammatory drugs (NSAIDs)

Answer 31

aspirin, ibuprofen, acetaminophen, and other analgesic drugs that relieve pain and reduce inflammation at the site of injured tissue

Question 32

prostaglandin

Answer 32

the chemical substance responsible for localized pain and inflammation; prostaglandin also causes free nerve endings to become more and more sensitized as time passes

Question 33

counterirritation

Answer 33

analgesia in which one pain (for example, a pulled muscle) is relieved by creating another counteracting sensation (such as rubbing near the site of the injury)

Question 34

transcutaneous electrical nerve stimulation

Answer 34

a counterirritation form of analgesia involving electrically stimulating spinal nerves near a painful area

Question 35

cognitive behavioral therapy

Answer 35

a multidisciplinary pain-management program that combines cognitive, physical, and emotional interventions

Question 36

catastrophizing

Answer 36

an error in thinking in which a person believes something, such as pain, is far worse than it actually is

Question 37

sensory focus

Answer 37

attending directly to the sensations of a painful stimulus without necessarily trying to change those reactions

Question 38

cognitive reappraisal

Answer 38

a key component to CBT that focuses on helping individuals reinterpret pain-related sensations, restructure maladaptive thought patterns, and make positive self-statements

Question 39

pain management program

Answer 39

an individualized, multimodal intervention aimed at modifying chronic pain through neurological, cognitive, and behavioral strategies

Question 40

analgesia

Answer 40

inability to feel pain