Pain Flashcards
Acute Pain
- Something happened and its going to pass
- Caused by soft tissue damage- leads to infection or inflammation
Chronic Pain
- May have no apparent cause
- Can trigger other issues
- Be difficult to assess and diagnose
Types of Chronic Pain
- Chronic Benign: 6+ months. Ex. Back pain
- Recurrent Acute Pain: Intermittent episodes. Ex.TMJ, Migraine.
- Chronic Progressive. 6+ months, increasing severeity.
Prevalence and Impact
1/10 Canadians
Higher rates in women and elderly (65)
What Makes Pain Difficult To Study (3 things)
Culture: some report pain sooner vs other cultures don’t talk about it
Gender: women more sensitive, aware of pain and willing to report it- menstrual cycle
Coping: Catastrophizing = more pain
Resilience and positive emotions = less pain
Psychological disposition and approach directly effects pain **
Personal Report Pain
Useful when used correctly- can exaggerate and withhold
Subjective
Measuring Pain (Verbal and Pain Behaviour)
Verbal: Doctor says “is it throbbing or shooting”
PB: observable that arise from pain. Ex. avoidance of activity, facial expressions,
PAIN IS BPS MODEL_ Psychosocial, behavioural, physiological
Nociception
Dorsal Root Ganglia
Polymodal Nocicieption
N: System that carries signals of pain to brain
D: Can detect mechanical, thermal and chemical stimuli
PN: Able to detect and interpret various types of info from sources
Peripheral Nerve Fibers
A-Delta Fibre: Small, myelinated, opens gate, transmit sharp/first pain
C-Fibres: Unmyelinated, transmit secondary or aching pain, opens gate
A-Beta Fibres: Large myelinated, transmits info about position, closes gate.
More open = more pain
More closed= less pain
Theories of Pain- Traditional Model
Degree of pain is dictated by tissue damage.
Implication: a paper cut can be more painful than a stubbed toe
Theories of Pain- Gate Control Theory
“pain gate” can open/close to modulate pain signals to the brain
Weaknesses:
- Unable to explain phantom limb pain - Neuromatrix theory- have representation of ourselves, takes awhile to adapt and realize we don’t have that arm anymore.
Other Factors that can contribute to opening/closing the gate
Physical: Extent of injury OR medications or massage
Emotional: anxiety OR positive emotions
Cognitive: focusing on pain OR distraction of pain through activities
Beta-endorphins
Proenkephalin
Prodynorphins
Our bodies produce all of these
B: project to limbic system
Proe: quick movement across our whole body- CNS
Prod: in guit, pituitary and brain
Traditional Pain Management Techniques
Pain medications
Surgery
Sensory techniques - massage
Psychologist: BPS model, Biofeedback: HR,BP getting these symptoms and knowing a migraine is coming.
Pain & Personality Traits * Know this
Chronic pain patients show elevated scores in: hypochronia, hysteria and depression
Called NEUROTIC TRIAD
Associated with depression, substance abuse and anxiety **
