Pain

Question 1

What is Nociceptive Pain?

Answer 1

Nociceptive pain is physiological pain produced by noxious stimuli that activate high-threshold nociceptive neurons.

Question 2

Is Nociceptive Pain good or bad?

Answer 2

Nociceptive pain is adaptive, allows healing and is protective.

Question 3

What is Gate Theory?

Answer 3

Gate Theory describes interactions between nociceptive and non-nociceptive inputs.

The gate control theory of pain asserts that non-painful input closes the “gates” to painful input, which prevents pain sensation from traveling to the central nervous system. Therefore, stimulation by non-noxious input is able to suppress pain.

Question 4

What are the 4 General Types of Pain?

Answer 4

Nociceptive, Inflammatory, Dysfunctional and Neuropathic

Question 5

What is Referred Pain?

Answer 5

Pain localized to a site distant from where it’s coming from. This is related to Visceral Pain.

Question 6

What is Inflammatory Pain?

Answer 6

Inflammatory pain is a protective pain. It produces pain hypersensitivity during healing.

Question 7

What is Tactile Allodynia?

Answer 7

Tactile Allodynia occurs when normally non-painful stimuli become painful.

(I.e. Touching a sunburn is hurtful!)

Question 8

What is Hyperalgesia?

Answer 8

Hyperalgesia is an exaggerated response to a normally painful stimulus.

Question 9

What Causes Hyperalgesia?

Answer 9

Hyperalgesia is mediated by mast cells, neutrophils and macrophages.

It leads to the release of Interleukins, NO and Bradykinins.

Question 10

What is Dysfunctional Pain?

Answer 10

Dysfunctional pain is neither protective nor healing.

Question 11

What goes on in Dysfunctional Pain?

Answer 11

There is no known structural nervous system lesion or active peripheral inflammation in Dysfunctional Pain.

Question 12

What type of pain is Fibromyalgia?

Answer 12

Fibromyalgia is an example of Dysfunctional Pain.

Fibromyalgia occurs when there is body pain in joints and muscles.

Question 13

What is Primary Erythermalgia?

Answer 13

This is a type of Dysfunctional Pain. Primary Erythermalgia is a rare disorder that occurs when there are red, warm and burning sensations in the hands and feet.

Question 14

What Causes Primary Erythermalgia?

Answer 14

Primary Erythermalgia is caused by a Na+ channelopathy, which is associated with gene gain of function mutations. The mutations are maladaptive and persistent.

Question 15

What is Neuropathic Pain?

Answer 15

Neuropathic pain is a maladaptive pain caused by lesion diseases that alters neurotransmission. Pain is felt in the absence of a stimulus.

Question 16

What are some CNS causes of neuropathic pain?

Answer 16

CNS: Stroke, spinal cord injury/lesion, MS

Question 17

What are some PNS causes of neuropathic pain?

Answer 17

nerve trauma, toxic and metabolic neuropathies, Herpes Zoster (Shingles), AIDS

Question 18

What is Central Sensitization?

Answer 18

Central Sensitization is a maladaptive plasticity that contributes to persistent pain states.

Question 19

What Causes Central Sensitization?

Answer 19

In Central Sensitization, abnormal activity leads to compensatory changes on the post-synaptic side: more NT release, more channels in the membrane, more activity, greater number of NMDA glutamate receptors are added to the membrane and the strength of the synaptic signal becomes permanently enhanced.

Question 20

How does Tactile Allodyina occur?

Answer 20

Tactile Allodynia occurs through collaterals between nociceptors and mechanoreceptors!

Question 21

How do you treat Neuropathic Pain?

Answer 21

Antidepressants, anticonvulsants, Calcium channel anticonvulsants, Opioid Agonists, Cannabanoids, Topical Therapy

Question 22

What do Descending Systems do for pain?

Answer 22

Descending Systems (using the NT Serotonin and Norepinephrine) drive enkephalin-containing spinal interneurons to inhibit pain transmission.