Psychological perspective on pain Flashcards
What is pain? (textbook definition)
An unpleasant //sensory and emotional //experience associated with, or resembling that associated with, actual or potential tissue damage
note there’s multiple aspects////
Difference between pain and nociception?
Yes, they are different
pain cannot be inferred solely from activity of sensory neurons
Pain is often not proportional to damage
‘pain is a decision made by our brain’
What does this lecture want to communicate?
ALL PAIN IS REAL PAIN
believe people because those pretending are so few and far between, not worth trying to pick them out
Why do we experience pain? (as normal)
For protection…
Brain has many sources of information to make these pain decisions
What can contribute to pain decisions in the brain?
body/nervous system
attention
expectation
past experience (inc trauma)
thoughts/words e.g. giving a diagnosis
senses
emotional state
feedback/response- how you react
etc…
Why do SOME PEOPLE experience less pain?
lecture recording 12.16 - feedback/response
How can pain be understood in DIMs and SIMs?
danger in me - dims
safety in me - sims
Theory that brain responds with pain when DIMs are more prevalent than SIMs
Can be mental as well as physical
Sensitisation and reinforcement
Longer term pain, neurons that fire together find it easier to fire together again
commonly used pathways are more easily activated
‘smudging’ - less able to differentiate between specific source of pain
How does the situation of sustaining an injury affect pain?
The situation happening at the time
How people around them react
e.g. athlete vs computer programmer breaking their leg
e.g. those who have been abused, body in a psychological state of threat
Characteristics/ definitions of acute pain?
Warning
Explanation can be found
Can be cured
Time limited
Sympathy/believed
Goes back to ‘normal’
Characteristics/definitions of chronic pain?
Nuisance - no useful warning purpose
Explanation not always possible
Managed, not cured
Ongoing
Less validation/belief
Life affected there onwards
What are 2 common responses to pain?
‘take it easy trap’/avoidance
activity cycling ‘boom and bust’
What is the ‘take it easy trap’?
Had acute pain, get told to rest initially, ‘take it easy’
Pain never leaves
Stay in that cycle
Avoid activities associated with pain
Reduce activity - lead to negative problems
Get conditioned to respond to the pain as if it were acute, even when the pain is no longer serving a purpose
What are problems with the ‘take it easy trap’?
Less and less done over time
Loss of social contact
Loss of fitness and deconditioning
Depression
Reinforcing messages from the switchboard
How to help with the ‘take it easy trap’?
Staying active (within ability)
‘Motion is lotion’
Pacing
not ab removing pain, ab managing it
What is the boom and bust cycle? What are the problems?
Push through the pain, get the jobs done
Flare up, so forced to rest
Jobs build up so as soon as rested get them all done
Another flare up
Boom and bust
Damage-
Pain threshold becomes lower
Deconditioning the body, over time they experience more pain from doing less and quicker/more severe
What are the 3 P’s that help with managing pain?
Pacing
Prioritising
Planning
How can pacing help with pain?
Keep to a regular to a regular amount of activity, limiting time spent on an activity to prevent marked increases in pain
PLANNING not just going according to how you feel
Frequent short breaks, breaking larger tasks into smaller
How can planning help to manage pain?
Think when and how activities are done
Spread out difficult activities
Balance essential and non-essential activities
Take regular breaks
How can prioritisation help to manage pain?
Making difficult choices about what is done/what isn’t
Balance what needs to be done with what is pleasurable or interesting
Challenges of the 3 P’s?
Sacrifice involved, a lot of difficult decisions in lifestyle?
What methods other than the 3 P’s can be used in pain management?
Practicing relaxation - natural response to pain is muscle tension, make pain experience worse, relaxation has to be learnt
Distraction - block out/supress - can be difficult bc pink elephant is pain
Mindfulness - acceptance of experience
Changing the relationship with pain
What is a ‘flare-up’?
Increase in a patient’s usual pain - NOT new pain sensations
Can occur quickly with no warning or gradually over time
How can pain flare ups be managed?
Medication
3 P’s
Distraction
Support from others
Counter stimulation
Breathing control and relaxation
etc….
