lecture 10: pain experience and response recording

Question 1

pain definition

Answer 1

an unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 2

pain experience

Answer 2

• traditional biomedical: severity is proportional to tissue damage and thee is an organic explanation
• biopsychosocial: psychologicla and social factors included in diagnosis, severity, and treatment

Question 3

pain pathway

Answer 3

• sensation: activation of organ –> neural impulses to brain
• perception: brain’s organisation and interpretation of sensory input

Question 4

describing pain

Answer 4

socrates:
- site
- onset: what were you doing when it start(-s/-ed)
- character: type ie dull, twisitng, sharp, tense
- radiation: does it move
- associated symptoms: ie nausea vomitting
- timing: is it constanct, or does it come and go
- exacerbating symptoms: what makes it better or worse
- severity: how bad?

Question 5

why feel pain?

Answer 5

• prevents tissue damage (protect or prevent further)
• promotes immobilisation so you can heal

Question 6

pain-related behaviour

Answer 6

• outward exression
• attempt to reduce
• attempt to cope or ignore
• behaviours can impact the way we perceive and experience pain

Question 7

three theories of chronic pain

Answer 7

• gate control theory
• operant conditioning theory
• cognitive behavioural theory

Question 8

gate control theory (pain)

Answer 8

a gate exits at spinal chord that can block some pain signals. two way input
- ascending: biological in nature (receptors) and modulated by non pain stimuli like touch and pressure
- descending: psychological that is modulated by attention, emotional

Question 9

operant control theory (pain)

Answer 9

pain behaviours create a cycle of chronic pain where patient receives rest and/or attention which can then increase the expression of pain in the future. Or you do something, it causes pain, you don’t do it again or ask for help, further reduction in the activities doesn’t address root of pain, it might get worse

Question 10

cognitive behaviour theory (pain)

Answer 10

cognitive triangle, (thoughts, behaviour, feelings, all influencing each other). role of a patients appraisals (experience, perception) and coping strategies (responses) is important

Question 11

treatment of chronic pain for gate control

Answer 11

focus on treatments that can close the gate (not necessarily cutting of the connection to the brain)
- rubbing
- distraction
- relaxation exercises
- non- traditional therapy like massage,, acupuncture

Question 12

treatment of chronic pain for operant control

Answer 12

-decrease unhelpful behaviours like avoidance
- increase helpful behaviours like exercise/relaxation

Question 13

treatment of chronic pain for cognitive behavioural

Answer 13

transition patients from passive coping towards active coping (shift from avoidance, ignoring, increase clinician visits to regular exercise, distraction, relaxation)
- develop skills to change negative thoughts and behaviours

Question 14

chronic primary pain

Answer 14

pain that
- persists or recurs for longer than 3 months
- is associated with significant emotional distress and/or functional disability
- includes symptoms not better accounted for by another diagnosis