Chronic pain syndromes: Fibromyalgia Flashcards
What is the difference between acute and chronic pain?
Acute pain lasts less than 3 months and is related to tissue injury, while chronic pain lasts longer than 3 months and persists beyond the expected healing time.
What are the main categories of pain?
Nociceptive, neuropathic, mixed, and central pain.
What are the two subtypes of nociceptive pain?
Somatic pain (from skin, muscles, bones) and visceral pain (from internal organs).
What are key characteristics of neuropathic pain?
Burning, tingling, shooting sensations caused by nerve damage or dysfunction.
What is the role of nociceptors?
They are sensory receptors that detect harmful stimuli and transmit pain signals.
What are first-line treatments for neuropathic pain?
Antidepressants (TCAs, SNRIs) and anticonvulsants (gabapentin, pregabalin).
How do NSAIDs relieve pain?
By inhibiting cyclooxygenase (COX) enzymes, reducing prostaglandin production, and decreasing inflammation.
What are the adverse effects of opioids?
Sedation, respiratory depression, constipation, tolerance, and dependence.
What is the mechanism of action of local anesthetics?
They block sodium channels to prevent nerve impulse conduction.
What are common risk factors for developing chronic pain?
Surgery, trauma, nerve injury, psychological factors, and genetic predisposition.
What is the role of serotonin and norepinephrine in pain modulation?
They inhibit pain signals by modulating neurotransmission in the spinal cord.
What is the significance of wide dynamic range (WDR) neurons?
They integrate and transmit both noxious and non-noxious stimuli in the dorsal horn of the spinal cord.
What are non-pharmacological pain management strategies?
Physical therapy, cognitive-behavioral therapy (CBT), acupuncture, and mindfulness practices.
How does central sensitization contribute to chronic pain?
It amplifies pain signals and reduces the threshold for pain perception.
What diagnostic tools are used for neuropathic pain?
Quantitative sensory testing, nerve conduction studies, and patient-reported pain scales.
What factors increase the risk of opioid misuse?
Personal or family history of substance abuse, psychiatric conditions, and chronic pain duration.
What is multimodal analgesia?
Using different classes of analgesics to target multiple pain pathways for better pain control.
What is the function of NMDA receptor antagonists in pain management?
They block NMDA receptors to reduce central sensitization and chronic pain.
How does capsaicin cream work for pain relief?
It depletes substance P from nerve endings, reducing pain transmission.
What are the primary symptoms of fibromyalgia?
Widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive issues.
What is the pathophysiology of neuropathic pain?
Nerve damage leads to abnormal nerve firing and increased pain sensitivity.
What is opioid-induced hyperalgesia?
A paradoxical response where prolonged opioid use increases pain sensitivity.
How do TCAs provide pain relief?
They block the reuptake of serotonin and norepinephrine, enhancing pain inhibition.
What are the side effects of NSAIDs?
Gastrointestinal irritation, renal impairment, cardiovascular risks, and bleeding.
What are examples of adjuvant analgesics?
Antidepressants, anticonvulsants, muscle relaxants, and topical agents.
Why is patient education important in pain management?
It enhances treatment adherence, improves outcomes, and reduces fear or anxiety about pain.
What are red flags for serious underlying causes of pain?
Unexplained weight loss, fever, neurological deficits, and history of cancer.
What are the goals of pain management?
Reduce pain intensity, improve function and quality of life, and minimize side effects.
How do SNRIs treat neuropathic pain?
They increase serotonin and norepinephrine levels to modulate pain signals.
