Chronic Pain

Question 1

what is pain?

Answer 1

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage

Question 2

What is pain influenced by?

Answer 2

thoughts, activities, mood, sleep and stress

Question 3

What is acute pain?

Answer 3

serves a useful protective function to warn of danger or injury

Question 4

What is chronic pain?

Answer 4

Chronic pain is associated with a hypersensitive nervous system and usually no longer warns of damage

Question 5

What is the aim of pain management?

Answer 5

Aim of pain management is to ‘turn down’ a hypersensitive nervous system, reduce pain, and improve function and QOL

Question 6

What is the OT role in pain management?

Answer 6

• To enable people to participate in meaningful activities. Common strategies include:
  o Activity management - including activity analysis, skill development, activity adaptation, problem-solving, prioritising, and activity pacing
  o Education
  o Training of coping skills
  o Relaxation training and stress management
  o Environmental modification

Question 7

What is classified as chronic pain?

Answer 7

Chronic pain is defined as pain that persists longer than 3 months or that which has persisted beyond ‘normal’ healing times

Question 8

What is non-specific chronic pain?

Answer 8

pain that persists in the absence of injury or disease.

Question 9

What are the different types of pain?

Answer 9

Nociceptive
Neuropathic pain
Nociplastic or central sensitisation pain

Question 10

What is nociceptive pain?

Answer 10

Can be explained by a direct biomechanical response

Question 11

What is neuropathic pain?

Answer 11

Usually is where the dermatomes of the spinal nerves are injured, and you have pain over the distribution of the central nervous system or over the dermatomes

Question 12

What is Nociplastic or central sensitisation pain?

Answer 12

Not explained by direct tissue damage

Question 13

What type of phrases can you use with a chronic pain patient?

Answer 13

• ‘I can be sore, but I will be safe’
• ‘lotion is motion’
• ‘my harms will not harm me’

Question 14

What is involved in the ‘explain pain’ assessment?

Answer 14

• Routine assessment should provide many educational targets
• “are you really interested in knowing (why you’re hurt)?”
• How do you like to learn?
• Identify obstacles to the intervention
• “have a go” at level of misconception
• Where is knowledge currently accessed?
  o Eg. Dr Google, reputable source? Multiple sources?
• Consider if there are any chronic pain influences on learning
• Build a curriculum during the assessment
• Use “E-Flags” or run a Protectometer