Pain and Inflammation Flashcards
Acute Pain
- Frequently results from a disease, injury, or inflammation
- Sudden onset
- Short duration (<6months)
- Resolves with Healing
Chronic Pain
- Considered a disease
- Persistent
- Continues after healing
- Resistant to majority fo medical treatments
- Can be influenced by environment and psychological factors
Nociceptive Pain
- Physiologic
- “Normal” pain transmission
- Tissue injury
- Pharmacologic management: Nonopioids, opioids, local anesthetics
Neuropathic
- Pathologic
- Abnormal processing
- Pharmacologic management: Adjuvant analgesics
Somatic Pain
- Skin, bone, muscle, soft tissue
- Well localized
- Sharp, burning, gnawing, throbbing, cramping
- Intermittent or constant
- Acute or chronic
Inflammatory Pain (Inflammatory Joint Diseases)
- Inflammatory joint diseases
- Acute or chronic
- Signs & symptoms: swelling, tenderness, deformities, limitation of motion
- Treat with anti-inflammatory meds
Visceral Pain
- Diffuse, not well localized
- Nociceptor stimulation in abdominal or thoracic organs and tissues
- Dull, aching, cramping
- Referred
Neuropathic Pain
- Injuries to peripheral pain receptors, nerves or CNS
- Pain can arise from a stimulus that usually would not cause pain
- Shooting, burning, stabbing
- Difficult to treat
Nociceptive Pain Processes
- Transduction
- Nociceptors
- Inflammatory response - Transmission
- A-Delta and C Fibers - Perception
- Higher brain structure activation - Modulation
- Neurochemicals
Transduction
- If above needed threshold, the neuron will depolarize and trigger action potential
- Release of excitatory neurotransmitters and compounds
Transmission
Action potential
A-delta
- Glutamate
C fibers
- Substance P
Dorsal root ganglia
Spinal cord
Brain
A-delta fibers
Faster transmission
Lightly myelinated
Rapid reflex withdrawal
C fibers
Slow conduction
Unmyelinated
Poorly localized pain
Aching, burning
Glutamate
Binds to N-methyl-D-aspartate (NMDA) receptor
Promotes pain transmission
Secreted in spinal cord at A-delta nerve fiber endings
Substance P
Secreted at C nerve fiber endings
Opioids block at dorsal horn
Serotonin and Norepinephrine
Suppress nociceptive transmission
Perception
Higher brain structures are activated
Brain perceives pain