Effects of non-pharmacological and placebos treatments in pain management Flashcards
What is the general purpose of pain?
To draw attention to a potential/actual injury so that action can be taken for survival
Explain the 2 ways in which an individual can respond to pain?
Hypervigilance: giving abnormal focus to pain that no action can be taken for, which could increase pain intensity
Distraction: shifting focus from pain, which can decrease pain intensity
What is the difference between chronic pain and acute pain in terms of how the pain occurs?
Acute pain has clear occurrence, but chronic pain has less clear cause for occurrence as there’s no ongoing pathology/injury or healing
Do acute and chronic pain have psychological components that need to be assessed and managed, and how does this affect the overall resolution of the pain?
Acute pain has good likelihood for resolution with healing/recovery as it usually doesn’t include psychological components
Chronic pain usually has psychological component also needs assessing, possibly managing too so resolution is more difficult
What percentage of the general population is affected by chronic pain?
20%
Are psychological or biomedical factors stronger determinants of case outcomes?
Psychological factors are stronger determinants of outcome than biomedical factors
According to studies, which 3 populations’ persistence of pain and disability has strongest association with distress and severity of pain onset?
Community, workplace, post-surgical populations
What 3 aspects of pain are influenced by an individual’s attitudes and beliefs?
Pain origin, severity and their response
What are the 4 key psychological factors that influence how an individual responds to pain and processes its severity?
Cognitions (attitudes, beliefs)
Pain behaviour
Coping strategies
Emotions and distress
What is meant by cognitions of pain, and give 4 examples of cognition aspects?
Thoughts about pain that influence pain experience and response
Includes anxiety-provoking thoughts, catastrophising, rumination, expectations
What is meant by overgeneralisation of pain, and how is this an anxiety-provoking thought?
Overgeneralisation occurs when patient believes that pain will stay forever and never get better
which causes anxiety as patient worries about how this will affect their whole life which they cannot cope with
How does jumping to conclusions lead to anxiety-provoking thoughts?
Patient immediately considers more unfavourable outcomes and worst-case scenarios
which makes patients anxious as they become more uncertain about whether their own prognosis will be the same
What is meant by ‘should’ thinking, and how is this an anxiety-provoking thought?
‘Should’ thinking occurs when patient believes that they should be doing something different according to what they have previously observed eg. My lump should’ve been gone by now but isn’t
Causes anxiety as patient thinks that they are not responding to pain in the ‘normal’/’right’ way, which indicates to them that something is wrong with them
What is meant by catastrophising, and explain 2 ways in which this can present in an individual’s response to pain?
Magnification: “I become afraid that the pain will get worse”. “I wonder whether something serious may happen”
Helplessness: “I can’t go on”. “It’s terrible & will never get better”
What is meant by rumination, and how can this affect pain intensity?
Patient repetitively thinking about how much pain hurts, which can increase neural response to pain perception (which increases intensity), as they are constantly anticipating pain
Give 3 ways in which a patient’s expectations about pain occurrence, management and recovery can cause negative behaviour?
Patient has unrealistic expectations and so is disappointed and pessimistic when expectation isn’t met
Expecting an unfavourable outcome can drive negative behaviour
Impact when an expectation isn’t met
Give 3 examples of poor outcomes that arise from negative emotions generated by pain?
Slower recovery
Higher reporting of pain intensity
Length of sick leave taken
Describe the 2 characteristic features of generalised anxiety disorder, and the requirement to confirm a diagnosis?
Characterised by excessive anxiety and worry, occured on majority of days in past 6 months for official diagnosis
Give 5 symptoms of generalised anxiety disorder, and 2 direct results of anxiety?
Symptoms: Restlessness, Fatigue, Difficulty concentrating , Sleep disturbance, Marked muscle tension
The anxiety itself can cause distress and impairment
Why is patient education an important intervention for anxious patients with chronic pain?
Educating patient helps them understand that their chronic pain has been thoroughly investigated and doesn’t indicate underlying pathology
Give 3 examples of relaxation techniques used as interventions for anxiety?
Diaphragmatic breathing: stomach moves with each breath, which requires focus and so is a distraction
Guided imagery: visualising positive scenarios
Progressive muscle relaxation: slowly tense then relax muscles, demonstrates theory that you cannot have anxiety symptoms at same time as relaxation/well-being in body
Give 2 examples of psychological conditions that use Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) as interventions?
Anxiety
Depression
Give 2 characteristic features of depression, and how is it distinguished from low mood?
Characterised by persistent feeling of sadness and loss of interest
Clear diagnostic criteria to distinguish low mood from depressive illness disorder
Give 4 interventions for depression?
CBT/ACT
Patient education to understand that there isn’t underlying pathology
Realistic goal setting
Graded, paced activity and exercise that is slowly increased to participate in other activities such as hobbies, work
