Chronic pain syndrome Flashcards
What is the most common cause of long-term disability, with lost work days, in the US?
pain
What does persistent pain cause?
fxnal impairment and disability, psychological distress, and sleep deprivation. affects the quality of life
Define chronic pain
no biological value, has persisted beyond the normal tissue healing time
What does the DSM define chronic pain as?
persistent pain for six months
What are the three types of pain?
adaptive, inflammatory, maladaptive
Define adaptive pain
contributes to survival by protecting the organism from injury and promoting healing
Define inflammatory pain
preceded by injury at cellular level.
Define maladaptive pain
pain as a disease, abnormal sensory process, persisten or recurrent
Define hyperesthesia
increased sensitivity to stimulation, excluding the special senses
define dysethesia
an unpleasant abnormal sensation whether spontaneous or evoked
Describe psychogenic pain
physical pain that is caused, increased or prolonged by mental, emotional, or behavorial factors
What are some of the most common psychogenic pains?
headache, back pain, or stomach pain
Describe phantom pain
felt in a part of the body that has been lost or from which the brain no longer receives signals. a type of neuropathic pain
describe breakthrough pain
pain that comes on suddenly for short periods of time and isn’t alleviated by the patient’s normal pain management
What type of patient is likely to have breakthrough pain?
cancer patients
describe mixed chronic pain
may be mixed neuropathic/nociceptive pain present with advancing and changing disease.
What type of disease states are associated with mixed chronic pain?
migraines, cancer
What are the principles of chronic pain management?
An accurate diagnosis of pain syndromes, formation of a treatment plan
What are some goals of pain therapies?
reduction in intensity of pain, improvement of physical fxning, improvement of emotional fxning, improvement of quality of life, maintain dignity
What are the A’s of pain treatment outcomes?
analgesia, activities of daily living, adverse effects, aberrant behaviors
What are four types of pain therapies?
cognitive/behavioral, functional restorative, pharmacologic, interventional
Describe cognitive/behavioral aspects of pain management.
deals with the meaning of pain, the emotional background, and coping skills
When are invasive procedures used to treat pain?
when pain or SE persist despite comprehensive trials of pharmacologic therapy
What are some invasive procedures used to treat pain?
neurolytic blocks (celiac or hypogastric plexus), intra-spinal drug delivery, anesthesiologic
What are the different anesthesiologic pain treatments?
central nerve blocks (spinal, epidural), peripheral nerve blocks (femoral, intercostal, ect), autonomic nerve blocks (stellate ganglion, lumbar sympathectomy)
What are some special techniques of pain therapies?
facet block, cryolysis, radio frequency, ablative
What is a facet block used to treat?
back pain
What is cryolysis used for?
nerve damage
What is radio frequency used to treat?
facet jt/nerve damage
What are some nociceptive pain disorders?
low back pain, myofacial pain, visceral pain, headache, TMJ
What are some neuropathic pain disorders?
post herpetic neuralgia, trigeminal neuralgia, complex regional pain syndrome, phantom pain
What are some of the major causes of low back pain?
prolapse inter-vertebral disc, facet jt degeneration, sacroiliac jt arthritis, musculoskeletal disorder,
What are some red flags of low back pain?
loss of bowel/bladder control, fever, saddle parathesia
What are some musculoskeletal causes of myofascial pain?
abnormal muscle stress, poor posture or static position for prolonged period
What are some vitamin deficient causes of myofascial pain?
anemia, low Ca/Mg/K, low vitamins C, B-1/6/12
What are some miscellaneous disorders that can cause myofascial pain?
radiculopathy, visceral diseases, depression, hypothyroidism, hyperuricemia, hypoglycemia
What are some treatments for myofascial pain syndrome?
massage therapy using trigger-pt release, physical therapy, pharmaceuticals
What are some primary headaches?
migraines, cluster, tension, TMJ, Sinus, medication overuse