Pain management Flashcards
What are some definitions of pain?
Whatever the patient says that it is, whenever it is
A personal experience influenced by biologic, psychological, and social factors.
Pain and nociception (the process by which the body’s nervous system detects and responds to harmful stimuli, such as tissue damage or extreme temperatures) are different.
Learned through an individual’s life experiences.
Serves an adaptive role.
Expressed in many ways—not just verbally
What is the Gate Control theory?
The process by which the body’s nervous system detects and responds to harmful stimuli, such as tissue damage or extreme temperatures.
Small- and large-diameter nerve fibers conduct and inhibit pain stimuli toward the brain.
Gating mechanism determines the impulses that reach the brain
What are the 4 steps in the pain process?
1) Transduction
2) Transmission
3) Perception of pain
4) Modulation
Explain Transduction.
Activation of pain receptors. There is then an electrical impulse that travels from the periphery to the spinal cord at the dorsal horn from the conversion of painful stimuli into electrical pulses.
Explain transmission.
Transmission of pain along pathways from the receptors. A Delta and C Delta fibers. This is the pathway of the sensation of pain from the site of an injury or inflammation that are conducted to the spinal cord and then to the higher centers. This is typically that time where you’ll pull back from whatever is causing you pain.
Explain perception of pain.
Awareness of the characteristics of pain. This involves the sensory process that occurs when a stimulus for pain is present and how the patient may be perceiving that pain. Some may have a higher pain tolerance than others, so this perceived amount of pain may differ for each individual.
Explain Modulation.
Inhibition or modification of pain. This is the process by which the sensation of pain is inhibited or modified. Neuromodulators are regulated or modified by the sensation of pain. Endorphins, dynorphins, and enkephalins are examples of neuromodulators.
If you touch a hot plate and pull back your hand, which of the 4 steps of the pain process would this be?
Transmission.
What are the 2 different durations of pain?
Chronic & Acute
What are the 5 different localizations of pain?
Localized
Somatic
Visceral
Cutaneous
Referred
When it comes to pain, what should we do when we are trying to understand the pain of our patient?
P : Pain - can the patient describe the pain, give it a number on the pain scale. If they are not describing it are there any non-verbal cues?
T : Time - When did the pain start, how long has it been going on? Is it constant or intermittent?
L : Location - where is it hurting, is it radiating, is it changing location?
E: Etiology - Did it happen after the patient ate something? Could it be a side effect to a medication?
What is cutaneous pain?
Superficial pain.
What is somatic pain?
Deep pain
What is visceral pain?
Not localized pain but can be pain in abdomen or thorax region.
(Not specific to a particular area)
What is neuropathic pain?
Caused by a disease or lesion in the peripheral or central somatosensory nervous system (an example is phantom pain)
What is nociceptive pain?
Pain that occur during the natural pain process ex if you touch something hot.
What is nociplastic pain?
chronic pain that occurs when pain-related sensory pathways in the brain and spinal cord are altered, causing pain without tissue damage.
What is intractable pain?
Pain when there is a resistance to assistance or treatment given.
What is meant by acute pain?
Rapid in onset, varies in intensity and duration
Protective in nature
What is meant by chronic pain?
May be limited, intermittent, or persistent
Lasts beyond the normal healing period
Periods of remission or exacerbation are common
What are the 5 different etiologies of pain?
Nociceptive - Normal reaction to painful stimuli
Neuropathic - Caused by disease or lesions.
Nociplastic - chronic pain without any tissue damage (chronic and primary ) Occur with misdiagnosis.
Intractable
Phantom
What are the 3 responses to pain?
Behavioral (Voluntary)
Physiologic (Involuntary)
Affective (Psychological)
What are some factors that may affect the pain experience?
Cultural and ethnicity variables
- Family, biologic sex, gender, and age variables
- Religious beliefs and spirituality
Environment and support people
Anxiety and other stressors
Past pain experience
When describing the quality of pain, what are some words that we use to understand what they pain may feel like?
Sharp
Dull
Diffuse
Shifting
