Pain mechanisms + how to manage them

Question 1

Chronic pain

Answer 1

Can be in absence of an identifiable initial injury

Question 2

The Pain Triumvirate

Answer 2

Sensory/discriminative- location in time/space, assessment + intensity
–> lateral thalamic nuclei
Affective/motivational- emotional/unpleasant aspects
–> medial thalamic nuclei
Cognitive/evaluative- interpretation of pain + its meaning
–> cognitive system- ACC, DLPFC

Question 3

Major depressive disorder

Answer 3

Pain intensity increases with MDD severity

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

Question 4

Chronic pain neurotransmitters

Answer 4

5HT
NA
DA
Opioid 
Dysfunction in 1 or more --> Chronic pain

Question 5

MDD neurotransmitters

Answer 5

5HT
NA
DA
Opioid 
Dysfunction in 1 or more --> MDD or anxiety

Question 6

5HT

Answer 6

Suppresses sensation of normal bodily functions

Question 7

NA

Answer 7

Suppresses sensation of normal bodily functions

Question 8

DA

Answer 8

Application of importance and focuses attention

Dampens pain

Question 9

Opioid system

Answer 9

Prevents spread of pain, dampens pain, reinforces behaviour