Lecture 4.1 - Pain Management Flashcards
Adaptive pain is…
physiologic and protective
ie. learning to avoid to touch hot stove
Maladaptive pain is…
pathophysiologic and harmful
Pain is purely….
subjective
Who is at risk for under treatment?
Elderly and young people (toddlers/babies) due to inability to communicate or rate their pain
Acute pain duration
< 3 months duration
Chronic pain duration
> 3-6 months duration
Types of pain
Nociceptive
Neuropathic
Central (or functional)
Malignant (pain from cancer)
Acute pain
usually nociceptive
causes: surgery, acute illness, trauma, labor, post-op etc
Chronic pain
defined as pain which lasts beyond the ordinary duration of time that the body needs to heal itself
Pathophysiologic pain is….
distinctly different from nociceptive pain
Disengaged from noise stimuli or healing
Often described in terms of chronic pain
results when damage to PNS or CNS
Types of chronic pain
- Pain that persists beyond the normal healing time for acute injury
- Pain related to chronic disease
- Pain without an identifiable organic cause
- pain associated with cancer
Treatment goals of acute vs chronic pain
acute: Cure
Chronic: more difficult to manage, functionality
Pain management step ladder
Step 1 = Mild pain (1-3/10)
Step 2 = Moderate pain (4-6/10)
Step 3 = Severe pain (7-10/10)
Questions to ask when assessing pain?
- Description of symptoms
- Location
- Acute v Chronic, time of occurrence
- Severity
- Exacerbating factors
- Steps already taken
- Impact on daily living activities
- Psychological impact
- Social impact
Clinical presentation of acute vs chronic pain
Acute: sharp, dull, shock-like, tingling, shooting, radiating, fluctuating in intensity, varying in location….occur in timely relationship WITH a noxious stimuli
Chronic: sharp, dull, shock-like, tingling, shooting, radiating, fluctuating in intensity, varying in location….occur WITHOUT a timely relationship with an noxious stimuli
