Pain

Question 1

what makes up a chronic pain team

Answer 1

Interdisciplinary pain team 
Both mental and healthcare 
Multidisciplinary collaborators 
Physical therapy 
Schools 
Biopsychosocial vs. Biomedical

Question 2

Clinic demographics

Answer 2

Age: 
8-12 – 41%
13-17 – 54%
70% female 
Pain location #1
Head and neck
Abdomen
Lower extremity

Question 3

Definition of pain

Answer 3

A complex response to tissue damage or the threat of tissue that is related to sensory and cognitive-affective factors
Pain is whatever the person says it is

Question 4

Acute pain

Answer 4

Caused my injury and illness
Most pain goes away as soon as an injury heals or as an injury heals
Useful protective
Taking it easy helps recovery

Question 5

Chronic pain

Answer 5

Cause by injury or illness but it is different because it lasts longer than expected
Pain persists
Rest makes it worse
Pain > 3 months
Pain can be constant (all the time) or episodic (off and on)
Most common are headaches

Question 6

Gate control theory of pain

Answer 6

CNS
Spinal cord
Gates open or close
Brain
Brain stem can inhibit messages by production of endorphins
Chronic pain goes through the hypothalamus and limbic system
Brain systems attach to cognitive and affective meaning to them
PNS
Nerves outside the brain and spinal cord
A-delta fibers (fast) – acute
G-delta fibers (slow) – chronic pain

Question 7

Factors that open the chronic pain gates

Answer 7

Injury
Muscle tension 
Stress
Cognitive factors 
Emotional factors 
Not exercising/overdoing it

Question 8

Factors that close chronic pain gates

Answer 8

Relaxation
Managing stress
Activity/exercise

Question 9

Stress

Answer 9

Imbalance between the perceived demands from the environment and the individuals perceived resources to meet those demands 
Muscle spasms 
Restlessness
Headache
Chest tightness

Question 10

Headaches

Answer 10

20% of children b/w 5-17 experience chronic headaches 
Top 3
Dehydration
Poor food intake 
Stress

Question 11

Myofascial pain

Answer 11

Tenderness in muscles
Fibromyalgia
Hypermobility syndromes – kids that are stretchy and bendy (overuse)

Question 12

Complex regional pain syndrome

Answer 12

Go to books

Question 13

Functional GI disorders

Answer 13

Butterflies in my stomach
Chronic or recurrent GI symptoms 
Brain-gut axis 
Normal sensations perceived as pain 
Significant amount of stress receptors in intestinal tract

Question 14

Quality of Life for children with chronic pain

Answer 14

50% comorbidity with RAP and Anxiety. Less likely to report baseline anxiety but respond with same levels of anxiety

Question 15

the statistic of the number of

children who experience chronic head ache pain (see slide)

Answer 15

20%

Question 16

Parental catastrophizing

–

Answer 16

Parental catastrophizing significantly explained child’s disability and number of school sessions attended each week, beyond looking at child reports of pain intensity.
– Parents who catastrophize about their child’s pain are more likely to have children who are more disabled by pain