Pain Flashcards

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1
Q

Define acute pain.

A

Pain that is severe but comes on quickly and lasts of a relatively short period of time.

It is usually in a very specific location and has an identifiable source.

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2
Q

Define chronic pain.

A

Pain that lasts for a relatively long
period of time and is resistant to treatment.

It is likely to be the result of long-term behavioural factors such as physical exertion, or due to chronic illnesses such as cancer.

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3
Q

Define phantom limb pain (PLP).

A

Pain coming from the area where the limb is lost.

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4
Q

Describe the specificity theory of pain.

A

There is a separate sensory system for processing pain.

Pain receptors respond to stimuli and send electrical impulses to the brain. The brain processes the signal as the sensation of pain, and quickly responds with a motor response to try to stop the pain.

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5
Q

Describe the gate control theory of pain.

A

The spinal cord contains a gate that either prevents pain signals from entering the brain or allows them to continue.

Gating mechanism occurs at the dorsal horn where both small and large nerve fibres converge.

When there is more large fibre activity (such as touch sensation) compared to small fibre, people experience less pain.

When there is more small nerve fibre activity, pain can be sent to the brain so pain can be perceived.

Emotional states and expectations can also affect the intensity of pain.

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6
Q

Describe the study by MacLachlan et al.

A

It is a case study.

Sample consisted of a 32 year old individual named Alan who had a life-saving injury to remove his leg at the hip.

Alan experienced phantom limb pain. He tried several treatments but none of them worked so he decided to use mirror treatment as a last resort.

Alan followed a procedure which consisted of doing different exercises with a mirror. Eventually, he was able to do it by himself without a psychotherapist and a mirror present.

The study concludes that mirror treatment is effective at treating PLP in lower limbs.

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7
Q

Describe a subjective measure of pain.

A

Clinical interview using ACT-UP.

Activities
Coping
Think
Upset
People

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8
Q

Describe the McGill pain questionnaire (MPQ).

A

Consists of 78 words. Patients choose the best word that describes them. Each word has its own score based on severity. Total score ranges from 0 to 78.

The MPQ covers several categories such as pain descriptors, affective, evaluation of pain and miscellaneous.

The MPQ also asks a range of questions to measure the strength of the pain. Responses include mild, discomforting, distressing, horrible and excruciating.

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9
Q

Describe a behavioural measure of pain.

A

UAB pain behaviour scale.

Consists of 10 target behaviours such as verbal complaints, mobility, facial grimaces etc.

Observation is done by someone who lives with the patient over a period of time.

Each behaviour is assigned a mark of 0, 0.5 or 1 on its severity or frequency.

Score ranges from 0 to 10.

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10
Q

Describe Visual Analogue Scale (VAS).

A

Line of 100 mm long with two ends representing “no pain at all” and “extreme pain”.

The patient marks a point on the line to represent their current pain and this is converted to a numerical value based on the measured length between the mark and the end point.

Score ranges from 0 to 100.

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11
Q

Describe Faces Pain Rating Scale-Revised (FPS-R).

A

A scale showing 6 faces indicating increasing levels of pain. Faces might be coloured from green (no pain) to red (most pain) and there might be simple descriptions of pain below the faces.

Score ranges from 0 to 10.

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12
Q

Describe the aim of Brudvik et al. (2016).

A

To investigate the level of agreement of pain intensity when measured by children, parents and physicians.

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13
Q

Describe the sample of Brudvik et al. (2016).

A

243 children aged 3 to 15 years who attended a Norwegian emergency department.

51 physicians who did not specialised in paediatrics.

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14
Q

Describe the procedure of Brudvik et al. (2016).

A

Children aged 3 to 8 years used Faces Pain Rating Scale-Revised (FPS-R).

Children aged 9 to 15 years used Visual Analogue Scale (VAS) and Coloured Analogue Scale (CAS).

Parents and physicians completed Numeric Rating Scale (NRS).

Besides pain assessment, parents’ questionnaire also gathered demographics whereas physicians’ questionnaire gathered information about their medical experience, speciality and whether they had children.

The children’s diagnosis are classified as either infection, fracture or soft tissue injury.

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15
Q

Describe the conclusion of Brudvik et al. (2016).

A

In conclusion, the research showed that emergency department physicians significantly underestimate pain compared to parents and children. This is the case across all conditions and ages but is less likely to occur with fractures and less likely to occur with children aged eight and over.

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16
Q

Name the biological treatment for pain.

A

Analgesic.

17
Q

Name the two types if analgesic.

A

Opioid and nonsteroidal anti-inflammatory drugs (NSAID).

18
Q

Explain how NSAIDs work.

A

Reduce the production of prostaglandins.

19
Q

State the side effects of NSAIDs.

A

Indigestion, headache and drowsiness.

20
Q

Explain how opioids work.

A

Enter blood stream and attaches to opioid receptors in the brain to produce signals that reduce perception of pain and increase feelings of pleasure.

21
Q

State the side effects of opioids.

A

Drowsiness, slowed heart rate and addiction.

22
Q

State three types of cognitive strategy for pain management.

A
  1. Attention diversion
  2. Non-pain imagery
  3. Cognitive redefinition
23
Q

State two alternative treatments for pain.

A
  1. Acupuncture
  2. Transcutaneous electrical nerve stimulation (TENS)
24
Q

Describe attention diversion as a treatment for pain.

A

A person find ways to shift their attention from pain and onto something else instead such as a puzzle, music, counting and etc.

Effective at managing mild and moderate pain.

25
Q

Describe non-pain imagery as a treatment for pain.

A

A person thinks about a calm and relaxing situation rather than the pain.

The person is likely to slow their breathing, reduce heart rate and lower their blood pressure, which in turn helps to manage pain.

Usually an auditory recording is used to guide the person through different aspects of imagery.

Effective in managing mild and moderate pain.

26
Q

Describe cognitive redefinition as a treatment for pain.

A

A person replaces negative thoughts about pain with positive ones.

Coping statements are used to emphasize the person’s ability to tolerate pain.

Reinterpretative statements are used to remove negative associations from pain.

Effective in managing severe pain.

27
Q

Describe acupuncture.

A

It involves insertion of fine needles at specfic points of the skin to stimulate sensory nerves and produce endorphins which reduce
pain.

28
Q

Describe trancutaneous electrical nerve stimulation (TENS).

A

A mild electric current is passed between electrodes which are placed on the skin around the painful area.

This reduces the sensation of pain by flooding the nervous system, reducing its ability to transmit pain signals to the spinal cord and brain.