Neuromodulation of Pain/ Ethics/psycological aspects Flashcards
Tens for chronic pain
NO
EMS for care
efficacy of EMS for chronic pain
-helps promote active care
supplements for chronic pain
White willow (60-120mg day) Boswellia
Vits for chronic neuropathic pain (5)
E B1 B3 B6 B12
what us a medial branch block and what is it gold standard for
injection under fluoroscopy to dx and tx pain arising from facet jts
ethical guidlines for pain research in humans
- before starting any study, a proposed study must be reviewed by an independent committee
- ensure pts are not coerced or harmed
- evalutae pot for undesirable effects
fear memories and visual anticipation of a pain provocative event affects what brain structure
engage the ACC
In persistent pain what happens to the ACC
ACC expresses more NMDA receptors which increases susceptibility to fear anticipation
(memories of pain perpetuate the NMDA adaptations of the ACC)
what can block the formation of fear memories
NMDA antagonists (ketamine,dextromethorphan, amantadine) can block the formation of fear mems
what brain structures does central sensitization effect
involves the insult and ACC (as seen in fMRI)
how can NT affect central sensitization
the loss of dorsal horn interneurons
-cord glutamate expression overwhelms central GABA and glycine inhibitory paths
How does sleep disturbance influence pain
- Sleep deprivation prob acts thru the reticular formation to keep thamus timed with pain signals
- The spinothalamic tract passes thru the RF, inhibition of RF leads to sleep, sleep leads to less pain trans thru the spinothalamic tract
What did wall argue w pain
pain is a centrally mediated need state like hunger or thirst
what is scoring interpretation of waddles test
waddles is positive for symptom amplification or psychosocial overlay with a score of 3 or more out of 5
what is psychosomatic ilness
real physical illness arising from a primarily psychological source
Adverse childhood events and health outcomes (how many)
Ind with at least 4 ACEs were at increased risk of all health outcomes compared w individuals w no ACEs
why are pain avoidance behaviours bad
pain avoidance behaviours are self rewarding by minimizing incidents of pain intensity
-(must check in to what causes the pain so it still strengthens the association even w avoiding it
does an internal locus of control and acceptance of illness lead to better qol
yes
external vs internal locus of control
external- i don’t have control, i am powerless over the results of what happens to me
Internal- i have control, i can mamage the results of what happens to me
What is behavioural activtion
a CBT technique when one helps the pt identify meaningful activities and gets the pt to do more of these while decreasing the amount of time spent doing stressful stuff
