Pain + Chronic Pain management Flashcards

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1
Q

what is the difference between acute and chronic pain

A

acute pain resolves quickly, can be treated with medication and has a predictable prognosis. Chronic pain lasts 3 months or longer, multimodular treatment, unpredictable prognosis

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2
Q

what is chronic-recurrent pain

A

stems from benign causes and involves repeated and intense episodes of pain separated by periods without pain (ex. migraines)

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3
Q

what is chronic-intractable-benign pain

A

refers to discomfort that is typically present all of the time, with varying levels of intensity, and is not related to an underlying malignant condition

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4
Q

what is chronic-progressive pain

A

characterized by continuous discomfort, is associated with a malignant condition, and becomes increasingly intense as the underlying condition worsens. Two malignant conditions that frequently produce chronic-progressive pain are rheumatoid arthritis and cancer

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5
Q

what is the gate control theory of pain

A

Nerve impulses are transmitted from afferent fibers to the spinal cord, transmission cells modulated by a gating. Large-diameter fibers tend to “close the gate” by inhibiting transmission of pain signals while small fibers “open the gate” by facilitating transmission.

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6
Q

what are things that can open and close the “gate” in control theory of pain

A

Close = medication, rest, relaxation, counter stimulant (heat), distraction

Open = low mood, anxiety, anger/frustration, expectations, thoughts/beliefs (Pain catastrophizing)

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7
Q

what is the neuromatrix model

A

suggest the body is perceived in units of networks of neurons in the brain → possibly explains phantom limb pain

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8
Q

what is the fear-avoidance model

A

certain movements or behaviours become associated with pain, patients avoid these movement and catastrophize the pain that may be experienced, slowing recovery, develop fear of movement of of anxiety

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9
Q

what is the communications model of pain

A

suggests there is a chain of pain communication starting with (1) internal pain experience, leading to (2) verbal or non-verbal expression behavior of pain (3) the decoding of these behaviors by observers

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10
Q

what are secondary gains of pain

A

realizing pain results in special treatment from other –> gets others to do things for them

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11
Q

What are the three standard assessments for chronic pain

A

pain characteristics (duration, internity), pain impact (depression), personal and psychological history

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12
Q

how to asses pain in children

A

self reports from age 4, use face pain scales (child clicks the face they believe represents the amount of pain they are experiencing), youth and parental reports

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13
Q

what are the adaptive benefits to pain

A

beneficial for long term survival, warning signal that motivates behavior and facilitates learning, pain signal no longer adaptive in chronic pain

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14
Q

what happens when one develops a fear of movement

A

ear becomes associated with a number of daily activities, it elicits physiologic reactive and aggravates pain.

Fear of movement = best predictor of functional limitations than biomedical parameters

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15
Q

what is quota-based exercise programs

A

patient progressively increase their activity despite fear of movement

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16
Q

what are the consequences of pain catastrophizing

A

greater bodily pain, more medication, lower quality of life and higher depression, greater work disability an absenteeism

17
Q

what is positive and negative social reinforcements of pain behaviours

A

negative = avoidance of doing unpleasant tasks, positive = attention from others

18
Q

what were the results of the medical visit study (either told spouse or clerk is behind mirror)

A

if spouse was behind mirror, displayed more pain behaviours → spouses more likely to discourage patients from participating in physical tasks (enabling pain behaviors)

19
Q

what is solicitous communication

A

utterances reflecting concern about a pain patients condition or discontinued activity

20
Q

what are the consequences of disability payment

A

people receiving financial benefits from pain → pain treatment is less effective

21
Q

what is the best way to prescribe medication for chronic pain

A

Time-contingent medication rather than as needed → when as needed patients can catastrophize pain and take advantage of medication

22
Q

what kind of medication and treatments are prescribed for chronic pain

A

analgesics and narcotics → not sufficient for chronic pain management however, surgery (severing nerves that transmit pain signals) → only good for short term

23
Q

what are the principles of psychical stimulation for chronic pain

A

slightly stimulate nociceptors in one region to reduce overall pain (ex. Massage therapy, acupuncture, chiropractic therapy) → effective but effects short lived

24
Q

what is the goal of cognitive behavioral therapy for patients experiencing chronic pain

A

becoming more aware of pain related negative thoughts, more emotion expression (holding in emotion increases pain), teaching family members to reinforce positive behaviours: increased activity and Ignore negative behaviours: complaints of pain