Maladaptive Pain Responses

Question 1

Types of Pain

Answer 1

• Nociceptive pain
• neuropathic pain
• Neuroplastic pain

Question 2

Nociceptive pain “normal pain”

Answer 2

short duration, well localized, easing and aggravating factors, no electric qualities

Question 3

Neuropathic Pain “ electric/ nerve pain”

Answer 3

pain is at one location and travels along a dermatome or peripheral nerve pattern

Question 4

Neuroplastic Pain “Chronic/ Unexplainable Pain”

Answer 4

spread from original areas in non- dermatomal pattern, intensity is out of proportion from original injury

Question 5

Biomedical Approach - Chronic Treatment

Answer 5

• medical/ pharm treatments
• anatomic education
• emphasis on pain, not function
• facilitating avoidance

Question 6

Sales Pitch for Better Persistent Pain Treatment

Answer 6

• biopsychosocial approach, emphasis on PNE and developing therapeutic alliance with patients. focus less on diagnosis and more on changing maladaptive responses

Question 7

Maladaptive Responses

Answer 7

• catastrophizing
• fear avoidance
• kinesiophobia
• deconditioning

Question 8

Central Sensitization

Answer 8

overall description that explains why people develop chronic pain, becoming more efficient at feeling pain

Question 9

What do Changes of Properties in Neurons Within CNS means?

Answer 9

• pain no longer coupled with duration/ intensity of peripheral stimuli
• co- opts novel inputs into nociceptive pathways

Question 10

Effects of Sensitization

Answer 10

allodynia, hyperalgesia, secondary hyperalgesia

Question 11

Allodynia

Answer 11

pain evoked by normally benign stimulus such as cold, heat, or light touch

Question 12

Hyperalgesia

Answer 12

increase in perception of pain elicited by noxious stimulus

Question 13

Secondary hyperalgesia

Answer 13

spread of pain beyond initial site of injury. Caused by cortical smudging or synaptic adaptations

Question 14

Catastrophizing

Answer 14

worse case thinking; negative cognitive- affective response to actual or anticipated paintR

Question 15

Rumination

Answer 15

overthinking and worrying about pain

Question 16

What are the Behavioral Pain-Related Outcomes of Catastrophizing and Rumination

Answer 16

• increased behavioral pain expressions
• more illness behaviors
• higher pain severity, activity interferences, disability and depression
• alterations in social support networks

Question 17

Communal Context of Catastrophizing

Answer 17

evidence that catastrophizing is an interpersonal style of coping with pain designed to elicit support from others, affects care givers

Question 18

Fear Avoidance

Answer 18

Anticipated threat of pain causes hyper vigilance and monitoring of activities

Question 19

Roles of Stress on Pain

Answer 19

• stressors activate numerous systems ti achieve homeostasis
• sympathetic and parasympathetic balance
• prolonged stress = disastrous to body

Question 20

During Times of Stress

Answer 20

• amygdala activates the HPA axis via communication with hypothalamus
• hypothalamus releases CRH signaling pituitary
• ACTH acts on adrenals to release cortisol

Question 21

Patients Injured in Stressful Environments

Answer 21

7-8xs more likely to develop chronic pain

Question 22

Cortisol

Answer 22

helps respond to stress; mobilizes tissue substrates for fuel
- direct effects via redirection of energy and behavior alterations
- indirect effects via release and action of other hormones

Question 23

What Happens with Cortisol During Long Term Stress Effect?

Answer 23

Cortisol fails to function and we run out of fuel

Question 24

Lotus Control

Answer 24

persons generalized attitude or belief regarding causality between own behavior and consequences
internal : much of what happens stems from own actions
external : events in life are beyond ones control

Question 25

Benefits of Internal Locus of Control

Answer 25

- healthier lifestyle - greater perseverance in face of adversity