pain syndromes Flashcards
Affects more Americans than diabetes, heart disease and cancer combined
pain
the most common cause of long-term disability
chronic pain
Most common reason Americans access the health care system
pain
this kinda of pain alerts person to possible injury/condition
acute pain
this kind of pain is persistant, signals keep firing for weeks or years
There may be an initial trigger (injury or condition, serious infection, arthritis, cancer, etc.), but
many suffer w/o history of injury or condition
chronic pain
this kind of pain adversely affecting a person’s life physically, emotionally, and mentally
Can alter body at the cellular level
chronic pain
chronic pain includes
headaches, LBP, cancer, arthritis, neurogenic, and psychogenic (not due to past disease or injury)
pain classification
Can be based on pain physiology, intensity, temporal characteristics, type of tissue affected, or syndrome
Pain physiology (nociceptive, neuropathic, inflammatory)
Intensity (mild-moderate-severe; 0-10 numeric pain rating scale)
Time course (acute, chronic)
Type of tissue involved (skin, muscles, viscera, joints, tendons, bones)
Syndromes (cancer, fibromyalgia, migraine, others)
Caused by damage, injury, or inflammation to body tissue
Usually described as a sharp, aching, or throbbing pain
Usually associated with acute conditions
nociceptive pain
Associated with chronic pain
Occurs when there is damage, change, or problems to the peripheral nerves or CNS
Usually described as prickling, tingling or burning
Generally responds poorly to pain tx
neuropathic pain
A patient reports a pricking, tingling and burning sensation on the dorsum of her left hand. What type of pain is this patient describing?
a. Acute pain b. Nociceptive pain c. Chronic pain d. Neuropathic pain
neuropathic pain
what is gate control theory?
Pain impulses are “influenced” by a gating mechanism in the dorsal horn
Stimulating touch or movement sensation can close the gate, limiting pain impulse transmission
“non-painful sensations override painful sensations”
gating mechaniskm is controlled by
Gating mechanism is controlled by the activity in the large and small fibers
Large-fiber (A–alpha or proprioception/movement, A-beta or touch) activity inhibits (or closes) the gate
Whereas small fiber activity (pain) opens the gate
When gate is closed, small diameter pain fibers do not excite the dorsal horn transmission neuron
If pain information reaches a threshold that exceeds inhibition
It “opens the gate” and pathways to experience pain
Gating mechanism is influenced by nerve impulses that descend from the brain
3 influences on opening and closing the gate:
Amount of activity in the pain fibers
Amount of activity in other peripheral fibers
Messages that descend from the brain
neurophysiology of pain modulation: circles consist of what in the brain?
Circuit consists of periaqueductal gray (PAG) matter in the upper brain stem, locus coeruleus (LC), the nucleus raphe magnus (NRM) and nucleus reticularis gigantocellularis (Rgc)
neurophysiology of pain modulation: contribute to what pathway?
this inhibits what?
the descending pain suppression pathway,
inhibiting incoming pain
neurophysiology of pain modulation: opiods interact with what?
this causes what?
Opioids interact with the opiate receptors at different CNS levels, causing secondary changes which lead to neuronal electrophysiological change and modulation of ascending pain information
neuropathic pain causes
Infections & viral conditions
Compressive
Autoimmune
Congenital/hereditary
chronic pain treatment
Medications, acupuncture, local electrical stimulation, and brain stimulation, as well as surgery, etc.
Some physicians use placebos
Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification
Chronic pain sufferers found to often have lower than normal levels of endorphins in spinal fluid