Pain Flashcards
What was the early view on pain?
Biomedical view believed it was a response to external factors that is direct, causal and autonomic with no patient control. Only results from tissue damage, and the pain is proportional to the amount of damage.
What are the issues with the biomedical view?
Pts with the same degree of tissue damage report different levels of pain = tolerance varies.
Phantom limb pain.
Headaches are common but not due to tissue damage.
Pain from gross injuries may be overcome by other emotions
What is the gate control theory of pain? *
Input and output of pain are controlled by a spinal cord gate.
Input - Peripheral fibres send information to the gate whilst descending influence from the brain to the gate tells the psychological state of the individual e.g. expectations, modd, behaviour = influences if gate open or closed
Output - Gate integrates all input information and sends the output to an action system in the cortex for perception of pain.
Gate open = pain experienced.
Which fibres are involved in input? *
Small fibres carry pain stimuli
Large fibres inhibit transmission of small
What is the aim of pain management in regards to the gate? *
Aim to stimulate large fibres and keep the gate closed to alter perception and reduce experience of pain.
What factors will open the gate? *
Small fibre activation
Anxiety and worry
Boredom and focusing on pain especially if dehabilitating
What factors will close the gate? *
Physical - medication, large fibre stimulation
Emotional - happiness and relaxation
Behavioural - Intense distraction
What factors influence how pain is interpreted and tolerated?
Emotional and psychological state Memories of past pain experience Upbringing Gender Beliefs and values Social and cultural influences Attitude Expectations
What is the definition of chronic pain?
Long lasting, intense pain for >6 months. May be consistent or fluctuate. Usually rely on medication but it can become ineffective over time. Depression and anxiety are linked.
What is acute pain?
Mild/severe short lived pain
What are the 3 main categories used to manage chronic pain?
Pharmacology
Physiotherapy
Psychology
Other than medication what methods can be used to manage chronic pain?
Cognitive intervention to alter thoughts - distraction -imagery -hypnosis (deep state of relaxation allows suggestions to be take on) -counselling Behavioural interventions -relaxation exercises -biofeedback (using body e.g. monitoring HR as a sign of stress) -physical activity Treatment of depression and anxiety
How can pain be measured in adults?
Subjective measures. Visual analogue scale McGill pain questionnaire Pain diary Observation
What are the advantages of a visual analogue scale?
10cm line to indicate extent of pain and amount of relief.
Can compare levels once treatment is started.
Easily understood
For >5 yrs
Measures severity, improvement and intensity.
Sensitive to small changes
What is the purpose of McGill pain questionnaire?
To measure the quality and emotional impact of the pain. Allows description of pain to be derived e.g. Cramping = soft tissue, Stabbing = nerve fibres
Uses a body map
