Inflammation and pain

Question 1

What is a inflammation?

Answer 1

• A non-specific protective response by our body and it is our first response to tissue injury
• Saves body at the price of tissue damage
• Goal is to replace injured tissue with healed tissue

Question 2

What causes inflammation?

Answer 2

• Infective agents: bacteria (septic reaction), virus, fungi, parasites
• Physical agents (non-septic): mechanical trauma, heat, cold, radiation
• Chemical agents (non-septic): organic/inorganic poisons

Question 3

Explain the inflammatory process and the following stages of healing

Answer 3

• Inflammation:
  1. Injured cells release inflammatory substances
  2. They cause vascodilation increases blood flow
  3. Leakage of blood into tissue letting cells start repair by removing damaged cells and let in immune cells
• Prolifiration: Scar tissue forms and vascularisation is restored
• Romdeling: Scar tissue matures, remodels, strengthens, and cellular organisation restores was there before (signs of inflammation are absent)

Question 4

What are the symptoms of inflammation?

Answer 4

• Pain
• Swelling
• Bleeding
• Redness
• Heat
• Limeted function
  Can also cause fever, fatigue, and loss of apatite

Question 5

Name som positives and negatives of inflammation

Answer 5

Positives:

• Necessary for healing
• Pain signaling something is wrong

Negatives:

• Autoimmune disease
• Scar tissue
• Pain limiting function

Question 6

How can inflammation be treated?

Answer 6

• Rest and decrease swelling during inflammatory/proliferation phase
• Carfully start to but strain on injury (may need orthotics) during remodeling phase
• Later: reduce use of aids

Question 7

What is pain?

Answer 7

Uncomfertable sensory and emotional experience with real or possible tissue injury

• Protective mechanism
• Subjective

Question 8

Which components does pain have?

Answer 8

• Sensory through sensory cortex
• Affective thorugh limbic system (emotions)
• Cognitive through frontal lobe (thoughts and actions affecting behaviours)

Question 9

Describe different pains in relation to duration

Answer 9

• Acute pain - A delta fibers: lasts less than 3 months, causes sweating, increase pulse and blood pressure, faster and shallow breathing, and distinct and clear pain
• Long term pain - C fibers: lasts longer than 3 months causing continous or preiodic pain

Question 10

Explain nociceptive pain

Answer 10

• As a result of inflammatiom where damaged cells releases protaglandins which stimulate nociceptors
• High stimuli threshold and slow adaptation
• Can be radiating - inflammatory substances travels
• Responds good to pain medication
• Divided into somatic pain - skin, muscle, bone, and focused on specific area; and visceral pain - internal organs and harder to localise and identify pain

Question 11

What can damage to nervous system cause?

Answer 11

Peripheral neuropathic pain:

• Projected pains like phantom pain = nerves are cut off and branches causing a neuroma sending impulses
• Carpal tunnel syndrome
• Nerve root compression ex. disc displacement
• Post-surgical due to nerve being cut off
• Radiating pain

Central neuropathic pain:

• Stroke, trauma to CNS, MS
• Surgery affecting CNS (scoliosis, tumor removal)

Question 12

How can pain be diagnosed and treated?

Answer 12

• Hard to diagnose since it is subjective
• Ratings - VAS scale
• Pharmacological treatment: Paracetamol (neuropathic) and NSAIDs (nocicepticve)
• Placebo affecting cognitive and affective components like reducing stress, anxiety, worry - our body’s own opioids
• Sensory stimuli lika TENS, heat/cold, physical activity
• Autonomous stimuli like breathing and yoga to decrease sympathetic activity and increases parasympathetic

Question 13

Other types of pain:

Answer 13

• Idiopathic pain - unexplainable, ex. whiplash
• Psychogenic pain - due to psycological reasons ex. PTSD, but no tissue damage