CHRONIC PAIN Flashcards
what is pain
Subjective symptom that causes the patient discomfort
Indicates tissue injury
what is sensory anatomy of pain
discriminative, helps localise the site of pain
what is affective anatomy of pain
carries information on the degree of pain
what is acute pain
Lasting minutes to 3 months
Reduces as injury/inflammation heals
what is cognitive anatomy of pain?
thoughtful planning to avoid + prevent further pain
what is chronic pain?
Pain lasting >3 months
Challenging to treat
Persistent, long term pain
what is primary chronic pain?
has no underlying condition or the pain (or its impact) appears to be out of proportion to any observable injury or disease
what is secondary chronic pain?
caused by underlying condition
what is the aetiology of chronic pain
Multifactorial problem
Involves the nervous system
Amplification of pain signals
Can be associated with an initial injury or inflammation to tissues, leading to:
Normal response or Abnormal response
what is the demographic risk factors?
- female
- age over 45
what is the socio-economic risk factors
- socio-economic deprivation
- unemployment
what are lifestyle risk factors?
- smoking
- alcohol
- inactivity
what are clinical risk factors
- multimorbidity
- obesity
- comorbid personality disorder
- psychological distress
- history of trauma or chronic pain
- sleep disorder
what are other risk factors
- family history of chronic pain syndromes
- pregnancy
- attitudes and beliefs about pain
what are the chronic primary pain examples?
- Chronic widespread pain
- Complex chronic regional pain syndrome
- Chronic primary headache & orofacial pain
- Chronic primary visceral pain
- Chronic primary musculoskeletal pain
What are the risk factors of chronic widespread pain
Female
Middle age
Low household income
Low educational status
Divorced & dramatic life events
what is chronic widespread pain?
- long lasting pain in multiple body regions
- hypothesised to be caused by aberrant peripheral and central pain processing
- no clear pathology
- fibromyalgia
associated with IBS + chronic headache syndromes
what are the associated symptoms with chronic widespread pain?
Fatigue
Concentration problems
Psychological distress
what is complex regional pain syndrome?
case unknown
thought to be result of body reacting abnormally to an injury
resulting in more sever pain which lasts longer than expected
what are the clinical features of complex regional pain syndrome?
Pain usually only affecting one limb
Allodynia/hyperalgesia
Burning/stabbing/stinging/tingling/numbness
Episodic flare-ups (often linked to stress)
Changes to skin/hair/nail growth in region affected
What is biomedical assessment?
- history
- physical examination
- investigations
- previous and current treatment
what is psychological assessment?
- assesses mood
- review psychiatric history, alcohol and illicit drug use, misuse, dependence or addiction, history of physical or sexual abuse
what is social assessment?
- ability to self-care
- occupational performance
- influence of family on pain behaviour
