Chronic pain

Question 1

what is the definition of chronic pain

Answer 1

pain that lasts for over 3 months. experience unpleasant emotional and physical sensation and not always related to injury.

Question 2

Types of chronic pain (7)

Answer 2

Chronic primary pain
Chronic cancer pain
Post traumatic/Post surgical pain
Chronic neuropathic pain
Chronic orofacial and headache pain
Chronic visceral pain
Chronic MSK pain

Question 3

What is the biopsychosocial model

Answer 3

Bio:
- physical health
- Neurochemistry
- Comorbidities
- Genetics

Psycho:
- Self esteem
- Perception of pain
- Coping mechanisms
- Stress

Social:
- Culture
- socioeconomic status
- family support
- interpersonal relationships
- work

Question 4

Aspects that can affect experience of pain

Answer 4

Perception of pain, stress, social support, nutrition/gut axis, depression.

Question 5

what is the gold standard of care for patients with chronic pain

Answer 5

MULTIDISCIPLINARY APPROACH

Question 6

What is PNE

Answer 6

Education on the physiological and biological processes of pain experience and de-emphasize pain coming from anatomical structures.

Question 7

Why is PNE important

Answer 7

Emphasizing pain related to anatomical structures increases patients fear, anxiety and stress.

Question 8

What is graded exercise

Answer 8

slowly increasing sets and reps once patient is able to do a certain amount without pain

Question 9

what is graded exposure

Answer 9

slowly increasing patients exposure to certain movements that they are scared of performing d/t possibility of it increasing pain.

Question 10

What are mindfulness interventions

Answer 10

Interventions that help people step back and reframe experiences. Goal is to pay attention to the present moment with openness, curiosity and acceptance.

Question 11

What are examples of mindfulness interventions

Answer 11

box breathing, thai chi, yoga, guided imagery, diaphragmatic breathing.

Question 12

Take home messages of chronic pain

Answer 12

-de-emphasize from biomedical/anatomical issues
-don’t focus on pain but rather on functional abilities
-use mindfulness techniques during sessions to make it more tolerable
-use patient reported outcome measures (PRO’s) to document progress.
focus on what the patient CAN do and not what they cannot do.
Be present and actually listen to what they are saying.