Pain Types and Viscerogenic Pain Patterns Flashcards
What are the three proposed mechanisms for referred visceral pain?
- Embryological development
- Multisegmental Innervation
- Direct pressure and shared pathways
Which of the three proposed mechanisms for referred visceral pain likely has a PRIMARY role in visceral pain patterns?
embryological development
Does assessment or measurement of pain provide a more robust and full picture of a patient’s pain?
assessment (history, physical exam findings, medication Hx, functional status, psychosocial and spiritual factors.)
Older adults often under-report or fail to report pain due to perceptions of reporting. Those include?
- Others perception
- Embarrassment
- Perceptions of exaggerated symptoms
- Fear avoidance
- Avoidance of medial settings
- Medications and treatment
- Cost
This pain type is often described as ‘sharp, shooting, burning, tingling,’ is not alleviated by opiates or narcotics, but local anesthesia may give some relief
Neuropathic
This pain type is due to unilateral stimulation of n. endings of somatic structures. It is often described as “dull, achy, gnawing, diffuse, and pressure.”
Somatic
This pain type occurs when emotional or psychological distress produces physical symptoms
somatoemotional
This pain type occurs when visceral structures affect the somatic musculature.
Viscero-somatic (ex: appendicitis causes rigid abdomen)
This pain type occurs when myalgic conditions cause disturbance of underlying viscera
somatovisceral
Deep somatic pain is associated with all of the following, EXCEPT:
a. “dull, achy”
b. autonomic phenomenon
c. good localization
d. periosteum, nerves, muscles, tendons, ligaments, blood vessels, cancellous bone, deep fasciae.
c. good localization
(Deep is poorly localized! Also responds to rest/NWBing and can refer to superficial structures)
Superficial somatic pain is associated with all all of the following, EXCEPT:
a. May refer to deep structures.
b. Well localized, pin point, sharp pain
c. skin/subcutaneous tissue (cutaneous), superficial fasciae, tendon sheaths, periosteum
d. trophic changes
a. may refer to deep structures (associated with referred pain, not to deep structures)
This pain type receives bilateral innervation causing “dull, achy, constant” pain not relieved with rest. Typically it is diffuse and poorly localized. If it refers - it does so in a dermatomal fashion. Pain is associated with inflammation/distention.
Visceral
This pain type is well localized, but might have poorly defined borders. It may spread and radiate from point of origin.
Referred
Nociceptive pain
Pain that arises from actual or threatened damage to non-neural tissue
neuropathic pain
pain caused by a lesion or disease of the somatosensory nervous system.
Nociplastic pain
pain in which no tissue damage is present to activate nociceptors or any other evidence of somatosensory disease.
Nociceptive pain is caused from
activation of nociceptors (inflammation, mechanical irritant, injury)
Neuropathic pain is caused from
lesion or disease of somatosensory system
Nociplastic pain is caused from
central pain processing disorder
Visceral tension
dissension of organ causing colicky waves of pain and tension
Inflammatory pain
deep/boring pain with poor localization involving the viscera, and more well localized when involving the parietal peritoneum.
Ischemic pain
due to loss of blood supply resulting in tissue death described as sudden, intense, constant, progressive, and non-responsive to analgesics.
Types of Muscle pain
Muscle tension, spasm, trauma
A musculoskeletal red flag indicating cancer or neurological impairment includes
proximal muscle weakness with a change in one or more DTRs.
