pain

Question 1

what is the definition of pain?

Answer 1

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

Question 2

define acute pain

Answer 2

a useful biological response provoked by injury or disease, which is of limited duration
responses are usually adaptive

Question 3

define chronic pain

Answer 3

pain persisting for 6 months or more and tends not to respond well to pharmacological treatment

Question 4

Briefly describe the gate control theory (background) of pain

Answer 4

• mechanism in the dorsal horn of the spinal cord
  -pain signals carried by nociceptors to the brain to be processed
  -pain signals can either be let through or restricted - ie the gate can be opened or closed
• open gate - pain signals sent through and pain is perceived
  -closed gate - pain signal is restricted

Question 5

what area specifically in the dorsal horn is the pain gate mechanism located?

Answer 5

the substantial gelatinosa

Question 6

Describe the 3 primary neutron types involved in the pain gate theory? (myelination? diameter? speed of impulse?)

Answer 6

• A beta fibres - large diameter, have quick transmission of impulses due to myelination
  -A delta fibres- smaller fibre diameter, thinly myelinated
  -C fibres - similar to A delta fibres, slowest transmission of impulse since they are not myelinated

Question 7

what stimuli activate the 3 primary neuron’s?

Answer 7

-A beta fibres - non noxious stimuli eg light touch, pressure and hair mvt
- A delta fibres - strong noxious stimuli eg pain and temperature, sharp intense sensations related to potential or actual damage to tissues
-C fibres - carry info about dull, throbbing pain, prolonged sensations

Question 8

how does anxiety and depression affect pain?

Answer 8

-decrease pain tolerance
- increasing reports of pain

Question 9

what is the anti pain fibre?

Answer 9

the A beta fibres - they are activated through rubbing, massage and heat and they act to inhibit the perception of pain

Question 10

what are examples of pain assessment?

Answer 10

• verbal rating scales - using words ranked in order of severity
  -visual analogue scale
  -Mcgill pain questionnaire consists of 20 descriptor scales

Question 11

what are the modern aims of pain management?

Answer 11

• reduce pain perception
  -improve coping ability
  -increase functional ability
  -decrease drug reliance & distress

Question 12

how does attention / focusing on pain affect the pain experience ?

Answer 12

focusing on pain increases the experience of pain

Question 13

how do we manage acute pain? first line vs second line

Answer 13

1st line - generally pharmalogical
2nd line - psychological intervention - hypnosis, increasing patient control, distraction, relaxation

Question 14

what are the 5 D’s that can happen as a result of people experiencing chronic pain?

Answer 14

-Dramatisation of complaints
-disuse through inactivity
-drug misuse through over medicating
-dependency on others
-disability due to inactivity