Pain

Question 1

What are the top 10 types of pain?

Answer 1

• Lemon juice poured on a paper cut
• Migraine headache
• Arthritis
• Proctalgia fugax
  
  • (Spasm in rectal area that is associated with irritable bowl)
• Trigeminal neuralgia
• Pancreatitis
• Labor
• Kidney stones
• Cluster headache

Question 2

How is pain dectected and sent to the brain?

(4 steps)

Answer 2

1. ·Transduction – detection of pain by PNA via Nociceptors (nerve endings that detect pain)
2. Transmission – propagation of pain signal from PNS to CNS

• 1. Nociceptor to spinal cord
• 2. Spinal cord to brain stem/thalamus
• 3. Thalamus to cortex

3. perception – the limbic system interpreting pain
4. modulation- the physical response to manage the pain (remove hand from fire)

Question 3

what do pts fear when going to the doctor with a chief complaint of pain?

(5 fears)

Answer 3

· 1. They wont be believed

· 2. The pain indicates something bad

· 3. The pain will get worse

· 4. The pain will never go away

· 5. They will get addicted to pain medication

Question 4

How does a physcian assess pain?

Answer 4

As the pt what you can do to help them with their pain

• by end of exam be able to graph the pain on an intensity vs. time graph
  
  • oscillating pain indicates hollow organ dammage (kidney stone)
  • pain rises and does not fall indicates tissue injury (sore throat)

Question 5

What soicial factors make pain less tolerable?

Answer 5

• Low workplace satisfaction
• low soical suppport at work/home
• gender
  
  • young men are worse at dealing with pain then women
    
    • estrogen is thought to play soem role in pain reduction
• personality traits (resiliancy)
• personality disorders

Question 6

Define egocentric bias and relate it to the social contract of being sick

Answer 6

people in pain become more egocentric and act as if the world should stop and help them reduce their pain

• pts in pain, especialy chronic pain tend to overstate their pain and abuse the rights granted by the sick social contract

Question 7

How does chronic pain affect pts psychosocially?

Answer 7

· Depression

· Anxiety

· Feelings of helplessness

· Irritability

· Social isolation

· Marital problems

· Lower sexual satisfaction

Question 8

What types of therapies can be used to treat chronic pain?

Answer 8

• Pharmacotherapy
• Physical and occupational therapy
• Implantable pumps to deliver medication directly to spine
• Spinal cord stimulation
• Complementary & alternative therapies
• Multidisciplinary pain clinics
• Behavior therapy
• Stress management
• surgery when indicated

Question 9

What types of psychological treatments can be used to manage chronic pain?

Answer 9

· Behavioral approach

· Progressive muscular relaxation

· Hypnosis