Intro to Pain Flashcards
what is the current formal definition of pain and what components must be included in the definition
an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage
- emotional and motivational component (affects mood to stimulate you into action)
the portion of the definition “resembling that associated with” decouples the need for what
for damage to actually happen to your tissues in order for you to experience pain
- tissue damage is neither necessary or sufficient for the experience of pain
what are the 6 key notes accompanying the pain definition
- pain is a personal experience that is influenced to varying degrees by biological, psychological and social factors
- pain and nociception are different phenomena, pain cannot be inferred solely from activity in the sensory neurons
- through life experiences individuals learn the concept of pain
- a person’s report of an experience as pain should be respected
- although pain usually serves an adaptive role it may have adverse effects on function and social and psychological well being
- inability to communicate doesn’t negate the possibility that a human or animal experiences pain
T or F: we don’t have pain receptors in our brain
T, we have nociceptors that respond to stimuli
T or F: pain can be more heavily influenced by either biological, social and psychological factors
T
what factors classify pain as ‘good pain’
predictable, known source/cause, known duration
known effective method for relief, long term effects not bad (maybe good)
what factors classify pain as ‘bad’ pain
unpredictable, unknown source/cause, unknown duration
unknown method for relief, unknown long term effects
what is an important factor when distinguishing good vs bad pain
context
- if you woke up with sore legs but didn’t go to the gym the day before (bad pain)
what are illness representations
how we make sense of symptoms, illness and injury
explain the gate control theory of pain
large diameter low threshold afferent neurons activate the interneuron in the spine which closes the gait to pain
small diameter high threshold afferent neurons inhibit the interneuron in the spine which opens the gait to pain
information coming from the large diameter afferent impairs the ongoing flow of information from the small diameter afferent
without the large diameter activity, information coming through the small diameter nociceptors is free to continue to flow
the brain can also send messages down to the spinal cord and regulate the amount of information coming from the peripheries itself (can close the pain gait)
differentiate between large diameter and small diameter afferents (high vs low threshold, depolarize in response to what)
large: low threshold, depolarize in response to low threshold things (touch, warmth, coolness)
small: high threshold, depolarize in response to high threshold things (mechanical - cutting, crushing, thermal - burning, freezing, or chemical - acid)
explain the inputs of the neuromatrix model of pain
for a pain experience to occur information has to be interpreted from the brain as potentially harmful according to 3 broad domains
1. cognitive-evaluative: past experiences, what does this mean
2. sensory-discriminative: where it is, what it feels like, how often it hurts
3. motivational-affective: mood, how do I feel at the time
explain the outputs of the neuromatrix model of pain
all of the input domains interact and lead to different outcomes
1. perception: the experience of pain, sensory, affective and cognitive dimensions
2. action: motor system activity, involuntary and voluntary (withdrawing a limb)
3. protection: fight or flight, cortisol, NE, endorphin levels
explain the mature organism model of pain
information comes from our tissues, travels from the spine to the brain
the brain considers past experiences, knowledge, beliefs, culture, past behaviours and then we take appropriate action
leans into social, environmental and cultural influences
we are all functions of the environments in which we’ve grown up
explain the biopsychomotor model of pain
pain is not only the experience but also the behaviour, pain can be a communicative tool
we have reactions to pain which elicit responses from others and based on those responses (supportive vs punitive) it influences how you respond to pain or how you communicate pain in the future
explain the multimodal assessment model of pain
the persons pain experience is separated from the observer
the closest thing we can get to the patient’s true experience of their pain is their narrative
pain measures are another step removed from the person’s true experience
