Temporal & Mechanistic categories of Pain Flashcards
What is temporal pain?
the duration of the pain
Temporal aspect of pain is important for what?
for our understanding and appropriate treatment of pain
Categories of temporal pain?
Transient nociceptive pain
Acute pain
Chronic pain
What is transient nociceptive pain?
unpleasant sensation in response to noxious stimuli that does not injure tissue
How is transient nociceptive pain categorized?
by temporary unpleasant discomfort by noxious stimulus that does not result in tissue damage
What does transient nociceptive pain include?
- first pain (A delta)
- second pain (C fibers)
What serves as an “early warning sign” that alerts the brain to the presence of potentially tissue-damaging events?
transient nociceptive pain
What triggers behavior aimed at avoiding harmful stimuli?
transient nociceptive pain
What is acute pain?
unpleasant sensation in response to tissue injury and/or inflammation
What is recurrent acute pain?
pain that returns periodically but in distinct episodes
What type of pain (acute/chronic/transient) is elicited by tissue damage and inflammation that activates nociceptive afferent neurons at the site of local damage?
Acute pain
Acute pain:
Local tissue damage and inflammation temporarily alters the response of what?
Peripheral nociceptors (peripheral sensitization) as well as their central connections (central sensitization)
What does acute injury-induced physiological changes produce?
hypersensitivity
hyperalgesia & allodynia
What happens in acute pain that promotes healing and prevention of further injury?
Acute pain signals the presence of tissue damage and activates physiological and behavioral mechanisms
Chronic pain
unpleasant sensation that persists longer than 1 month beyond the normal healing period or that is associated with a pathological process
what pain persists after the triggering event has resolved?
chronic pain
What pain is associated with a pathology, and can cause continuous pain over months or years?
chronic pain
Which pain is not understood to have a protective role?
chronic pain
Following the identification of the temporal category of pain, what else must be determined in order to select the appropriate treatment?
determination of the system affected
Pain can be broadly classified into two functional categories.
- Nociceptive pain
- Neuropathic pain
Is pure psychogenic pain possible?
yes, but rare and difficult to differentiate from the psychological component of pain
What is nociception pain further divide into?
somatic pain
visceral pain
inflammatory pain
Nociception of the mechanistic categories of pain occurs following….
mechanical, thermal, or chemical noxious stimulus
Nociception subcategories must be determined for proper what?
diagnosis and treatment
Inflammatory nociceptive pain is associated with the process of tissue repair following what?
tissue damage
What is neuropathic pain divided into?
neurogenic and functional pain
Which category of mechanistic pain is associated with nervous system disorder?
Neuropathic
What does treatment of neuropathic pain depend on?
whether the origin of pain is peripheral (e.g. diabetic neuropathy) or central (e.g. spinal cord injury)
Is it possible for a central component of pain to develop following peripheral pain?
yes
What is functional neuropathic pain defined as?
a dysfunction of the CNS that results in the excitation of neural systems that can enhance the perception of pain or through the inhibition of endogenous pain modulation system
Functional neuropathic pain has a neurogenic component but is better described as a dysfunction of what?
endogenous pain control mechanisms
- i.e. fibromyalgia and post-stroke central pain syndrome
Nociceptive:
Somatic (fracture, laceration) responses?
- superficial or deep pain
- nociceptive reflex
- autonomic response
Nociceptive:
Somatic (fracture, laceration) mechanisms?
Mechanical, chemical, or thermal stimulation
Nociceptive:
Visceral (colitis) responses?
- constant or cramping
- not well localized
- autonomic response
Nociceptive:
Visceral (colitis) mechanisms?
Distension of viscera
Nociceptive:
Inflammatory (arthritis) responses?
- spontaneous pain (diffuse)
- hyperalgesia
- allodynia
Neuropathic:
Neurogenic (neuralgia, spinal injury, thalamic injury, sciatic pain) responses?
- Spontaneous pain (sharp, electrical)
- Hyperalgesia
- Allodynia
Neuropathic:
Neurogenic mechanisms?
Peripheral or central nervous system injury
Neuropathic:
Functional (fibromyalgia, post-stroke central pain syndrome) responses?
- Spontaneous pain (diffuse, deep)
- Hyperalgesia
- Allodynia
Neuropathic:
Functional mechanisms?
Hyperactivation or loss of nociceptive tract inhibition
