Pain

Question 1

Define pain

Answer 1

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

Question 2

Why do we feel pain?

Answer 2

Early warning system
Alerts to danger
Waning of actual or potential harm
Elicits change in behaviour
To try and avoid danger/ harm

Question 3

What are the three different types of pain?

Answer 3

Somatic superficial, somatic deep, visceral

Question 4

Somatic superficial=

Answer 4

On the skin, sharp (fast) pain, localised (brief)

Question 5

Somatic deep=

Answer 5

In deep layers of skin, muscles and joints, is a burning/ itching/ aching (slow) pain, is diffuse (Long lasting)

Question 6

Visceral=

Answer 6

In organs, is a dull ache/ burning/ gnawing (slow) pain, can cause nausea and sweating

Question 7

Acute vs chronic pain

Answer 7

Acute= monetary or severe, weeks/ months, resolvable
Chronic= persistant, remains despite the healing process and lasts 3+ months

Question 8

What is the congenital absence of pain disorder?

Answer 8

Someones central perception of pain mechanisms are disrupted so no pain is felt. This means there is an issue with the SCN9A voltage gated sodium channel.

Question 9

Nociception=

Answer 9

neural process of encoding noxious stimuli

Question 10

Pain perception=

Answer 10

the body’s interpretation of these signals

Question 11

Nociceptor=

Answer 11

are sensory receptors that respond to pain. There are many types e.g., mechanoreceptors, bradykinin, prostaglandins, histamine, substance P. They are located on free nerve endings and respond to inflammatory mediators.

Question 12

What are the role of free nerve endings?

Answer 12

• Free nerve endings play an important role in nociception by detecting noxious stimuli. This initiates perception of pain.

Question 13

Describe the differences between Aɗ (A-delta) and C-fibres.

Answer 13

• Aɗ (A-delta) = sharp, pricking, fast pain. They are myelinated.
• C-fibres= hot and burning sensation, slow deep pain. They are un-myelinated.

Question 14

Describe the process of central sensitisation.

Answer 14

• Involves two types of presynaptic cells which are both glutamate receptors: AMPA and NMDA. If there is a transient stimulus of the nociceptor then AMPA receptors are activated, releasing sodium ions into the cell. On a stronger stimulus of the nociceptor, NMDA receptors are activated on the 2nd order neuron allowing release of calcium ions into the cell, increasing the sensitivity of the neuron.

Question 15

Describe the process of peripheral sensitisation.

Answer 15

• It is a substance P mediated feedback loop where 1st order neurons are sensitised. There is an increase in nociceptive neurons so the pain will just get worse and worse.

Question 16

Referred pain=

Answer 16

• When you have an injury in one area of the body, but the pain is felt elsewhere. For example: issues with the gallbladder can cause pain on the skin of the shoulder. This is because of the interconnecting sensory nerves of the body.

Question 17

What is the neuromatrix theory of pain.

Answer 17

• Suggests pain comes from a pattern of nerve impulses in the body. These impulses come from a neural network in the brain called ‘body’s-self neuromatrix’.

Question 18

Hyperalgesia=

Answer 18

• Increased sense of painful sensation, primary/ secondary.

Question 19

Allodynia=

Answer 19

• Pain from a stimulus that does not usually provoke pain.

Question 20

Explain the biomedical approach to pain.

Answer 20

• Pain is felt in response to a painful situation. Meaning pain is felt as a sensation and has a singular cause.

Question 21

What are the pain paradoxes.

Answer 21

• Battle wounds= Individuals with the same degree of injury will experience differences in reports to their painful situation. E.g., a study showed significant differences in soldiers requesting pain relief.
• Phantom limb pain= 5-10% of amputees will experience pain in their absent limb.
• Placebos.

Question 22

What is the biopsychological approach to understanding pain.

Answer 22

• Acknowledges that pain is not just a psychical phenomenon but also a social, psychological and biological response.
• Biological e.g., pain intensity, medication use and trauma/ injury
• Psychological e.g., depression, pain perception and fear avoidance
• Social e.g., work, disability, cultural and economic factors.