Pain mechanism and management Flashcards

1
Q

Define pain

A

An acute sensory or emotional experience that is associated with actual or potential tissue damaging injury

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2
Q

Features of acute pain

A
  • Specific injury
  • Tissue damage
  • Self limiting
  • Ceases once healing occurs
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3
Q

What is the gate control theory of pain

A

Pain is a perception rather than sensation

  • Opening/ closing of neural gates can control pain
  • Gate open- high pain. Gate closed- no pain
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4
Q

According to the model, what from the brain can activate gating mechanism

A

Anxiety, tension, depression, boredom, focus on the pain

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5
Q

According to the model, what (other than brain) can activate gating mechanism

A

Noxious stimulus activating a-delta and c fibres

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6
Q

What can inhibit the gating mechanism

A

Medication, pleasure, distraction, relaxation, analgesia, activation of a-beta fibres (counter stimulation)

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7
Q

What % of adults will suffer with chronic pain

A

25

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8
Q

What is the most common site of chronic pain

A

up to 2 years

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9
Q

How does chronic pain affect quality of life

A

Lose job
Major depressive disorder
Report wish to die
Suicide attempts

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10
Q

What is meant by ‘motivation’ in terms of chronic pain

A
  • How do we think about pain
  • How do we feel about pain
  • What do we do about pain
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11
Q

What areas of the brain have sensory/ discriminate roles in pain- what exactly is their role

A

Lateral thalamic nuclei, S1, S2, SMA

- Localisation of pain in time and space, assesses intensity

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12
Q

Whart areas of the brain have affective/ motivational roles in pain

A

Medial system: BG, medial thalamic nucleus, ACC, insula

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13
Q

What areas of the brain are to do with interpreting pain and its meaning

A

ACC

DLPFC

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14
Q

What aspects of pain are primary in

a) acute
b) chronic pain

A

a) sensory component is primary

b) affective and motivational components are primary

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15
Q

What is the triad of chronic pain

A

Pain
MDD/ anxiety
Addiction

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16
Q

How does pain intensity change with major depressive disorder severity

A

It increased

17
Q

How many sustained pain lead to mental illness

A

Sustained pain–> increased negative mood states–> more refractory pain–> ultimately MDD

18
Q

Name some systems in the brain that are dysfunctional in both MDD/ anxiety and chronic pain

A

5-HT
Noradrenaline
Dopamine
Opiod

19
Q

How does the serotonin behave in chronic pain/ MDD

A

Suppress sensation of normal bodily function

20
Q

How does the noradrenaline system behave in chronic pain/ MDD

A

Suppress sensation of normal bodily functions

21
Q

How does the dopamine system behave in chronic pain/ MDD

A

Application of importance, focuses attention and dampens pain

22
Q

Name the 4 types of pain behaviours

A

1- negative affect
2- facial/ audible expression of distress
3- distorted ambulation/ posture
4- avoidance of activity

23
Q

What is pacing

A

Combination of pain and activity avoidance- may implicate compromises to patient and suggest greater subjective disability

24
Q

What is biofeedback

A

Provides biophysiological feedback to patient about some bodily process the patient is unaware of (forehead muscle tension)

25
What is relaxation
Systemic relaxation of the large muscle groups
26
What is hypnosis
Relaxation, suggestion, distraction