Pain

Question 0

What is the difference between somatogenic and psychogenic pain?

Answer 0

Somatogenic pain is pain that originates from a physical cause ie trauma

Psychogenic pain has no apparent physical cause. This is not imaginary pain, it can be as intense as somatic pain. For example bereavement, depression. It can manifest in particular parts of the body, it is just not from an external stimulus.

Question 1

What is pain?

Answer 1

Pain is a perception, and not a sensation. The cause can be actual or potential tissue damage, but the pain itself only occurs onces we have processed the signals in the CNS.

Question 2

What is a good way of explaining how pain is processed?

Answer 2

A child falling over, does not immediately feel pain or distress. They have not yet learned how to process pain signals, so there is a few moments delay while the child processes the incident and decides how to react to the situation.

Question 3

What is acute pain?

Answer 3

Short lived pain, or pain that is not constant. Sudden onset

Question 4

What is chronic pain?

Answer 4

It is long lived or persistent, often caused by initial tissue damage. However this type of pain can remain long after the initial stimulus is removed. Often described as throbbing.

Question 5

What is nociceptive pain?

Answer 5

Pain which is caused by noxious stimulation, ie a physical causing of pain, which activates nociceptors. Ie pressure, cold or heat, chemicals

Question 6

What is neuropathic pain?

Answer 6

Pain caused by nerve damage.

Question 7

What is the pain threshold?

Answer 7

The level of noxious stimulus required to alert an individual of potential threat to tissue

Question 8

What is pain tolerance?

Answer 8

Amount of pain a person is willing or able to tolerate

Question 9

What is accommodation phenomenon in relation to pain?

Answer 9

Where sensory adapters adapt over time to a stimulus, receding sensitivity so that high level of pain does not continue.

Question 10

What is hyperesthesia?

Answer 10

Abnormal sensitivity to touch, pain or other sensory stimuli

Question 11

What is paresthesia?

Answer 11

Abnormal sensation such as burning,pricking, tingling?

Question 12

What is analgesic?

Answer 12

A neurological or pharmacological state in which painful stimuli are no longer painful

Question 13

What is allodynia?

Answer 13

Pain produced by a non noxious or non damaging stimulus

Question 14

What is anaesthesia?

Answer 14

Loss of sensation in a part or all of the body caused by a neurological change or pharmacological agent.

Question 15

What is the process of responding to pain?

Answer 15

Initial stimulus received, signals sent to the spinal cord where there is a reflex motor response and we react to stimulus. The signal is then relayed to the limbic centre in the brain, and only then is the pain felt.

Question 16

Why do we feel pain?

Answer 16

Reflex to he is avoid damage, ie responding to heat by withdrawal of affected area, preventing further damage.

We automatically protect the area that is painful, which allows the healing process to work effectively.

This also helps us learn to avoid similar situation in future as we associate that action with pain.

Question 17

What are nociceptors?

Answer 17

Sensory terminals, nerve endings, which are e

Sensitive to different types of stimuli dependant on the type of ion channels in the receptor.

Question 18

What are some different types of nociceptors?

Answer 18

Mechanical
Thermal
Chemical
Poly modal

Question 19

What is the gate control theory?

Answer 19

If we responded to every signal, the pain would be overwhelming. The spinal cord recives all these signals, and moderates which are sent onto the brain by reading all signals from that area and differentiating between normal activity and abnormal damage.

Question 20

What is referred pain?

Answer 20

Mix of signals received, and is perceived by the spinal cord as originating from an area that is it not from. IE feeling knee pain, when the signals of pain are actually from the hip. Normally nerves that enter the spinal cord at the same level

Question 21

What is phantom limb pain?

Answer 21

Feeling pain in a limb that is no longer there. Often in traumatic damage.

Question 22

What are endogenous modulators or pain?

Answer 22

Ways we modulate pain by producing pain relief in our own body. Two main categories.
Opioid peptides - endorphins
Endo-cannabinoids

Question 23

Why do drugs such a opioids provide pain relief?

Answer 23

We have opioid and cannabinoid receptors in our body for the endogenous compounds, but these can be stimulated by synthetic material such as drugs.

Both set of receptors are gPCR.

Opioid receptors are also found in the Gi, so a side effect to be expected from them is consipation.

Question 24

What are the effects of opioids in the body?

Answer 24

Highly analgesic
Sedative
Euphoric
Neuro protective
Gi problems such as constipation
Affect reward, emotion and stress - addictive

Question 25

What are the effects of cannabinoids in the body

Answer 25

Euphoric
Analgesic
Anti inflammatory
Anti convulsant

Question 26

What is the function of endogenous painkillers in the spinal cord? IE endorphins, enkephalins and endocannabinoids

Answer 26

Transmitters in the pain pathways, helps to modular severe trauma IE childbirth. Reducing pain but not affecting alertness.

One of the reasons post Natum depression as huge release of euphoric and pain reducing endorphins during delivery, sudden withdrawal of this feeling.

Question 27

What kind of painkillers are recommended for mild pain?

Answer 27

No narcotic analgesics.

Paracetamol and NSAIDS
Ibuprofen, aspirin, naproxen

Question 28

What type of painkillers are prescribed for moderate pain?

Answer 28

Weak opioids, opioid in combination, IE paracetamol and codeine

Question 29

What painkillers are used for severe pain?

Answer 29

Strong opioids, oxycodone, morphine sulphate, fentanyl, OxyContin.

These are the mostly likely to cause addictive behaviour/stimulate reward pathways and develop tolerance. Respiratory depression.

Question 30

When should NSAIDS be used, how do they work?

Answer 30

They block prostaglandin formation by inhibiting the enzyme COX peripherally and centrally. They are anti inflammatory. It is suspend that anti inflammatory drugs actually affect a large number of pathways that we do not know about yet.

Best used for inflammation or muscloskeletal disorders.