Lecture 1

Question 1

Definitions of pain (Understanding how pain is defined is important in order to learn how to better control it):

Answer 1

• Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage
• Pain is whatever the experiencing person says it is, existing whenever s/he says it does

Question 2

Types of pain (For the purposes of research and medical practice, pain can be separated into the following categories):

Answer 2

Acute, chronic, neuropathic, cancer

Question 3

Acute pain:

Answer 3

(considered a sx): 3-6 mo., or directly related to tissue damage

Question 4

Chronic pain

Answer 4

(not necessarily considered a sx): More than 3-6mo., or beyond healing; not understood as well as acute pain; two types

Question 5

Two types of chronic pain:

Answer 5

(a) due to an identifiable pain generator (injury): Due to a diagnosable anatomical problem. If not subsided after a few weeks/months of conservative treatments, then spine surgery may be considered
o (b) no identifiable pain generator (healed injury): Often termed “chronic benign pain.” Pain can setup a pathway in the nervous system and, in some cases, this becomes the problem in and of itself (sending pain signals after the fact; in other words, NS misfires and creates pain – pain becomes the disease rather than the sx of injury)

Question 6

Neuropathic/nerve/neuropathy

Answer 6

Feels different than musculoskeletal pain (e.g., sharp, lightening-like, burning, traveling down… etc.). In most types, all signs of original injury are gone/ pain felt is unrelated to an observable injury or condition; certain nerves continue to send pain messages to the brain, despite there no longer being tissue damage
o Thought that injury to the sensory or motor nerves in the PNS can potentially cause neuropathy
o Could be placed in the chronic pain category, but different feel than chronic pain of a musculoskeletal nature
o Different treatment options from other pains (e.g., opioids are not effective)
 Nerve “block” injections is one effective tx

Question 7

Acute vs. chronic pain

Answer 7

• Acute pain roughly correlates to the level of tissue damage/ provides us with a protective reflex, such as to stop an activity when it causes pain
• Chronic pain does not serve a protective or other biological function; tx will be different depending on the underlying cause of pain

Question 8

Chronic pain development

Answer 8

• Not all pain that persists will turn into chronic pain
  o Different people experience this differently
• Effectiveness of tx will vary
• Not understood why some people develop chronic pain, while others may not to the same injury