Definitions Flashcards
2020 definition of pain
An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage
is pain always a personal experience?
by what is it influenced
yes
it is influenced to varying degrees by biological, psychological and social factors
Nociception
the neural process of encoding noxious stimuli
order of action of nociception
- nociceptor
- spinal cord (spinothalamic tract)
- thalamus
- somatosensory cortex
noxious stimulus
a stimulus that is damaging or threatens damage to normal tissues
does nociception equal pain?
no
nociception is neither sufficient nor necessary for pain
T/F: nociception is the output of the brain
false
pain is the output
nociception -> modulation -> pain
chronic pain
mainly characterized as pain that has persisted for more than 3 months, with the implication that typical tissue healing time has passed
BPS perspective 1 is
causation (multifactorial) perspective
BPS perspective 2 is
humanistic (person-centered) perspective
Peripheral sensitization
- increased responsiveness of nociceptors to stimulation of their respective fields
- increased size of nociceptors’ fields
- reduced threshold of nociceptors to stimulation of their receptive fields
- activation of silent nociceptors
where is the pain modulated?
PNS and CNS
in other words, central sensitization is an
amplification of neural signaling within the CNS that elicits pain hypersensitivity
central sensitization
- increased responsiveness of nociceptive neurons in the CNS to their normal or subthreshold afferent input
- increased size of receptive fields for nociceptive spinal dorsal horn neurons
- reduced threshold of nociceptive spinal dorsal horn neurons to stimulation of their receptive fields
- temporal summation of pain = progressively increasing pain to the same stiimulus administered repetitively or over a long duration
hypoalgesia
diminished pain in response to a normally painful stimulus
hyperalgesia
increased pain from a stimulus that normally provokes pain
allodynia
pain due to a stimulus that does not normally provoke pain
pain threshold
the minimum intensity of a stimulus that is perceived as painful
evoked pain intensity
the intensity of pain evoked by a stimulus, measured numerically from 0-10
temporal summation
progressively increasing activity of the dorsal horn neurons in response to repetitive or sustained noxious stimuli
what is an important clue for central sensitization
temporal summation of pain
pain tolerance
maximum intensity or duration of a pain-producing stimulus that a subject is willing to accept in a given situation
pain behaviour
what a person does in reaction to pain (avoidance, withdrawal form painful stim, guarding, persistence, other coping, etc. ) or to express pain
layers of clinical considerations for pain
nociceptive pain
pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors
neuropathic pain
pain caused by a lesion or disease of the somatosensory nervous system
nociplastic pain
pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain
OARS
open-ended questions
affirming
reflecting
summarizing
therapeutic alliance
a trusting connection and rapport established between therapist and client through collaboration, communication, therapist empathy and mutual understanding and respect
therapeutic communication
listening
pain validation
pain neuroscience education
familiar terms
pain catastrophizing
an exaggerated threat appraisal of one’s pain
an exaggerated negative mental set brought to bear during actual or anticipated pain experience
magnification
the tendency to exaggerate the threat value of the pain
rumination
excessive focus/thinking about the pain
helplessness
perceiving myself as unable to cope with the pain
pain-related fear
usually refers to fear of the pain itself or fear of doing physical movement/ activity that could worsen the pain, injury, or cause re-injury
difference between pain catastrophizing and pain related fear
pain catastrophizing is mainly conceptualized as a cognitive interpretation of pain as threatening whereas fear is mainly conceptualized as an emotional reaction that motivates protective behaviour (avoidance)
active treatment
patient learns how to do the treatment from the therapist, and then applies it to themselves autonomously
passive treatment
the therapist applies the treatment to the patient
graded exposure to feared activities if
pain-related fear is elevated TSK
benefits of pain neuroscience education
supporting pain management principles
can decrease the threat value of pain (pain catastrophizing) and can also have an effect on decreasing pain-related fear
sleep deprivation
drowsiness
falling asleep very quickly
sleep hygiene tips can assist
make sleep a priority
insomnia
being awake when you want to sleep
sleep hygiene tips might not be sufficient
cognitive behavioural therapy for insomnia is recommended
insomnia definition
difficulties falling asleep and-or early awakenings without the possibility to go back to sleep
sleep apnea
makes people stop breathing for short periods of time during sleep
bruxism
grinding teeth during sleep
restless leg syndrome
unpleasant sensations in the legs that appear at the end of the day and usually worsen in the evening
periodic limb movement
stereotyped movement of the legs (ex every 10s) during sleep
REM sleep behaviour disorder
the loss of muscle atonia during REM sleep
people start acting their dreams
can become violent during sleep, nightmares of being attacked, safety issues for partner
trauma
experiences that cause intense physical and psychological stress reactions. it can refer to a single event, multiple events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.
chronic effects of toxic stress
hypervigilance
trauma informed care
