Lecture 4.2 - Pain Management

Question 1

Nociceptive pain is….

Answer 1

pain that results from injury to or inflammation of somatic or visceral tissues

its a mechanisms humans have adapted to protect us from actual & potential danger

Question 2

Nociceptive pain is responsive to….

Answer 2

typical analgesics

Question 3

Examples of Nociceptive pain

Answer 3

Paper cut
Burn
Arthritis
Trauma
Muscle strains or sprains
Tendonitis

Question 4

Agents used in nociceptive pain

Answer 4

OTC
Antidepressants (duloxetine )
Muscle relaxant's
Steroid injections
Hyaluronic acid injections
Cannabinoids

Question 5

Nociceptive Pain Pathway Steps

Answer 5

1. Stimulation
2. Transmission
3. Perception
4. Modulation

Question 6

Stimulation

Answer 6

Stimulation of free nerve endings = nociceptors

Responsible for starting pain signal

Determine what is harmful and

Question 7

Transmission

Answer 7

A & C fibers

A = large, myelinated, fast = sharp well localized pain

C - small, unmyelinated, slower = dull, aching, poorly localized pain

Question 8

2 processes for Transmission to be complete (pain felt)

Answer 8

Transmission from periphery to the spinal cord

Transmission from the spinal cord to the brain

Question 9

Stops of Transmission

Answer 9

1st = Spinal cord
2nd = Brain

Question 10

Adaptive inflammation

Answer 10

in response to trauma, body will purposefully cause inflammation/swelling

purpose is to decrease contact with and minimal movement to the injured area

Question 11

Central Sensitization

Answer 11

In response to tissue damage & inflammation, in CNS neurotransmitters change composition, transduction and transmission properties resulting in enhanced pain

Can lead to Hyperalgesia and Allodynia

Question 12

Hyperalgesia

Answer 12

Exaggerated pain response

Question 13

Allodynia

Answer 13

Painful response to normally non-noxious stimuli

Question 14

Neuropathic pain is due to…

Answer 14

damage or dysfunctional nerves

Question 15

Subjective view Nociceptive pain

Answer 15

dull, pain, cramping, aching

Response to typical analgesics

Question 16

Subjective view Neuropathic pain

Answer 16

burning, radiating, shooting, shock-like, electric, tingling

Poorly responsive to typical analgesics

Question 17

Maladaptive pain

Answer 17

sometimes called functional pain

Question 18

How many sites need to have pain to be diagnosed with Fibromyalgia

Answer 18

11 out of 18

Question 19

Agents used for Fibromyalgia

Answer 19

Physical modalities
OTC agents
Antidepressants
Antiepileptic-like gabapentinoids
Muscles relaxants
Cannabinoids

Non-weak/weak/opioids…not super effective