Pain Flashcards
What is pain?
Pain is a sensation of marked discomfort, distress, or agony, causing physical or psychological misery.
Why is pain useful?
The main function of pain is to serve as a signal that something is wrong with the body, to prevent further injury and to help with diagnosis.
Explain how pain is subjective.
A persons experience of pain is quite subjective as it has both a sensory (how intense it is) an affective (how unpleasant the feeling is to you) component to it.
State the 3 types of pain.
- Acute pain
- Chronic pain
- Psychogenic - Phantom Limb Pain
Describe acute pain.
- Sudden, sharp pain.
- Lasts for less than 3 months.
- Usually in a specific location from an identifiable source that will go away once issue is resolved.
- Symptoms show at random but don’t last all day.
Describe chronic pain.
- Pain that usually lasts longer than 6 months.
- Create long-term pain and exhaustion.
- Can affect their sleep and lifestyle.
State and explain each type of chronic pain.
- Chronic recurrent: comes in episodes.
- Chronic intractable: constant pain which differs in severity.
- Chronic progressive: constantly worsening.
Describe phantom limb pain.
- Type of pain typically experienced by individuals who have lost a limb.
- Pain is perceived to be originating from the missing limb.
- Pain is psychological due to inaccurate brain signals.
Explain the mirror treatment.
- An effective treatment for phantom limb pain.
- Uses a mirror to create the illusion of the amputated limb by placing the opposite limb in front of the mirror.
- Due to miscommunication in the brain, neurones send signals for movement to muscles from the amputated limb.
- When no signal returns it causes a conflict known as negative feedback.
- Mirror treatment tricks the brain into thinking the limb is moving.
Explain MacLachlan’s case study.
- Testing the effectiveness of mirror treatment.
- 32 year old, Alan, who had a leg amputated due to a rare bacterial infection.
- Suffered PLP 5 weeks after his amputation.
- Referred to a clinical psychologist.
- By the end of his third week of mirror therapy, he reported a reduction in his PLP and his pain ratings dropped from 5-9 to 0.
State the two theories of pain.
- Specificity theory - Descartes
- Control gate theory - Melzack
Explain the specificity theory.
- Suggests that pain is processed by a separate sensory system, much like other senses.
- Specialised pain receptors respond to pain stimuli such as extreme heat or pressure.
- The pain receptors send signals via nerve impulses to the brain and once the brain identifies the pain it triggers a motor response.
- Suggests that the more the pathway is used, the more intense the pain felt.
Explain the gate control theory.
- Proposes that pain signals passing through the spinal cord can be modulated by a gate that either allows or blocks these signals from the brain.
- This gate is located in the dorsal horn of the spinal cord.
- When large fibres are more active than small fibres, the pain gate closes reducing pain perception.
- When small fibres dominate, the gates open allowing pain to be perceived.
Explain clinical interviews in measuring pain.
- Used for assessing patients with chronic pain rather than focusing solely on physiological pain aspects.
- Examine psychological and behavioural factors that influence the patients subjective report of pain.
- The patient’s history and medical evaluation are completed during the interview.
Describe the MPQ.
- Self report questionnaire used by physicians to measure subjective pain experiences.
- Produces quantitative results.
- Dimensions of pain: location - description - severity - quality
- Patients are instructed to choose the word that best describes their pain.
- Also asked to mark where the pain is on a body chart.
- Rate the current pain intensity on a six-point scale.
Describe the VAS.
- A psychometric scale designed to measure an attitude, feeling or characteristic that cannot be directly measured.
- A 10 cm horizontal line, where the patient marks their current intensity of pain.
- Each end of the line represents the extremities of what is being measured.
Describe the UAB.
- The UAB scale targets 10 specific pain-related behaviours.
- An observer records these behaviours over a set period.
- Rates each behaviour daily, noting its severity, frequency or intensity.
- Summed out of 10, with a higher score indicating more severe pain.
Ways of managing pain.
- Biological treatment
- Psychological treatment
- Alternative treatment
State the types of biological treatments.
- Analgesics
- Anaesthetics
- Indirect pain relief medication
State the types of psychological treatments.
- Attention diversion.
- Non pain imagery
- Cognitive redefinition.
State the alternative treatments.
- Acupuncture.
- TENS
Describe Brudvick’s key study.
(aim – methodology – sample – procedure – results – conclusions)
- To examine the relationship between children self-reported pain and pain intensity ratings by parents and doctors.
- Field experiment at Bergen accident and emergency department, in Norway used questionnaires.
- 243 patients age 3 to 15, accompanied by parents and 51 doctors.
- Pain assessment, questionnaire details, diagnosis classification.
- Pain ratings were highest among children followed by parents then doctors.
- Importance of parental reports and the doctor significantly underestimate children’s pain.
