Chronic Pain Flashcards
Definition of pain
Unpleasatn sensory or emotional experience associated with actual or potential tissue damage
Chronic non-malignant apin
Lasts longer than expected tissue healing time (normally over 6 months)
Pain or any etiology or type NOT related to an active cacner
Internal vs. external pscyhopathology of chronic non-malignant pain
Internal - central sensitiization, psychiatric comorbidity, chronic illness
External - interpersonal issues, interactions with healthcare system, countertrasnferecne
Fibromyalgia
Widespread hyperalgesia/allodynia
Chronic somatic pain syndrome
Changes in pain processing
Visible on fMRI and higher levels of glutamate
Psychiatric comorbidities
Mood and addiction disorders
Psychological factors
Past history or trauam or abuse
Comorbid depression and anxiety
Active and passive coping styles
Active - BETTER, problem slving and attneding to emotional response
Passive - avoidance and escape, more depression and functional impairment
Lower self-efficacy
Goals of pain management
Decreased apin
Decreased healthcare utilization
Improved functional sttus
Mild
Mod
Severe
txs
Aspriin, NSAIDs, etc.
Codeine, hydrocodone, oxy, tramadol
Morphine, fentanyl, oxycodone, etc.
Adjuvants for chronic pain
ANti-epileptics - pregablin and gabapentin
Anti-depressants - TCAs and SNRIs
Opiods
GREAT for acute pain
OK for limited use in chronic pain or cancer apin
NOT good for chronic pain syndromes
Opioids for chronic pain syndromes
LImited data
No improvement in functional outcomes
