Pain: Clinician Flashcards
def. of pain
unpleasant subj. experience primarily assoc. with tissue damage or dercribed in terms of tissue damage
what is candian prevalence of chronic pain
29%
where do pain treatment disparities stem from
- healthcare system
- culture diffs
- clinician/patient interaction
def. of disease
specific clinical entity assoc. with disturbed function or structure of body
def. of illness
conception of sickness including
- symptoms
- interpretation
- expression of Sx
- coping behavs
4 aspects of biopsychosocial model
- sick role
- illness behavs.
- distress
- physical probs
what are psych aspects of pain
- basic cog. processes (attn., coping)
- social experiences
- pain behaviors
6 predisposing factors to chronic pain
- abuse
- marital discord
- fam. violence
- emot. trauma
- fam. members with chronic pain
- stress exposure
def. of chronic pain
> 6 months and beyond the normal healing time for an injury. Autonomic and reflex changes improve with time, but psych aspects tend to augment
what is main difference between chronic pain and chronic pain syndrome
sadness, hopelessness, social isolation, failed treatments, many doctors, demoralization
red flags for dev. of chronic pain disorder (6)
- intense and prolonged pain beyond that expected
- spreading and new pains
- failure to respond to treatments
- dev. of PTSD
- work difficulties
- inability of employer to give modified work
what is nociceptive pain
pain that is the result of the normal operation of the pain system and arises from injury
what is neuropathic pain
pain that arises from primary injury or dysfunction and nervous system reulting from injury to nerves, PNS or CNS
what can explain ritual pain tolerance
- endorphins
- altered mind states
- both
what are alpha and theta waves
alpha - normal 8-13 cyc/sec waves seen in everyday life
theta - 4-7 /sec waves seen in light sleep, deep thinking, and ritual pain experience
3 ways that hyponsis supresses pain
- splitting consciousness
- activation spinal cord descending pathways to block pain
- altering the meaning of pain
what is a placebo
ineffective treatment believed to be effective
3 things placebo can fix
- bronchospasm
- pain
- posture tremors
2 main types of MRI
- evoked responses in brain areas
2. correlated activity between brain areas (functional connectivity)
what does structural imagin find in pain
reduced grey matter volume in in cingulate and insular cortex
what is anterior ACC involved in
subjective pain perception
what is found in expert meditators
reduced pain unpleasantness and enhanced activity in the anterior insula and cingulate cotrex
2 therapies that can increase grey matter
- CBT
2. decreased pain catastrophizing
what is found in MRI in hypnosis people
greater functional connectivity between hemis on dorsolateral prefrontal cortex
what is placebo effect correlated with
increased white matter integrity
what are non-dermatomal somatosensory deficits
appear after traumatic injuries and are associated with bad prognosis for pain
