Pain Management Flashcards
Acute
“Pain that is usually temporary and results from something specific, such as a surgery, an injury, or an infection.”
Chronic
“Pain that lasts beyond the term of an injury or painful stimulus. Can also refer to cancer pain, pain from a chronic or degenerative disease, and pain from an unidentified cause.”
Referred
Pain felt at a site different from the location of the injured or diseased part of the body. Referred pain is due to the fact that nerve signals from several areas of the body may “feed” the same nerve pathway leading to the spinal cord and brain
Nociceptors
Nerve endings activated by noxious stimuli.
A-Delta
small, myelinated fibers. (A=acute)
Quick onset; short duration. Sharp/stabbing/prickling pains.
Located mainly superficially
C Fibers
small, unmyelinated fibers. Slow onset, long lasting. Dull ache, tingling, burning pain. (C=chronic) Located in deeper structures
A-Beta
larger, myelinated. FASTER than A-delta. Stretch, vibration and mechanoreceptors. In joints and skin
Pain threshold
level of stimulation required to activate the pain perception transmission.
Everyone’s threshold is different and can be manipulated by electronic stimulation or feedback.
Gate Theory
Since 1965
A-Beta fibers are nonnociceptive. Travel faster than A-Delta and C fibers. Therefore stimulus of A-Beta can block transmission of A-Delta and C closing the “gate” to the brain.
One reason why massage works and trigger point release works. Also used for TENS.
Limbic System
Emotional center of the body. Regulates autonomic nervous system (ANS).
Sympathetic Nervous System (SNS)
“Fight or Flight”. Located thoracic and upper lumbar spinal cord segments. Functions, increase CV, neuromuscular, respiratory, and neurologic function. Stimulated by fear, excitement, anger, pain, etc.
Parasympathetic Nervous System (PNS)
Opposes the SNS. Located: midbrain, pons, medulla, and sacral spinal segments
Relaxation response.
Decreased CV, respiratory, neuromuscular and neurological responses.
Calming effects.
Locus of Control
Ability to control life conditions and event
Internal
Outcomes are self determined.
External
Outcomes are determined by others.
Malingerer
a patient that continues to c/o pain even after stimulus has been removed. “Lingers” in symptomatic form or may have fabricated the symptoms in the first place. Defined as “intentional production of false or grossly exaggerated physical…symptoms, motivated by external incentives such as avoiding military duty, avoiding work, financial compensation, evading criminal prosecution, or obtaining drugs.”
Symptom Magnifier
“self-destructive, socially reinforced behavioral response pattern.” Patient focuses on symptoms and is unable to focus on rehab. Exaggerated reports of symptoms. Always 10/10.
**Be careful how you document either of these!!!
Depression
“morbid sadness, dejection, or a sense of melancholy, distinguished from grief…”
Dementia
Lack of intellect after age 18. Characterized by: progressive confusion, disorientation, memory loss, personality changes
Alzheimer’s Disease
Degeneration of limbic system and neuronal synapses. Progressive from mild to moderate to severe. common causes of death: infection or falls. Medication available: Aricept.
