test 3 pain Flashcards
what are challenges of pain disorders
- how would you describe this pain?
- underlying cause of pain?
- how intense is the pain?
- how do we alleviate pain?
what two factors is pain perception a combo of
1) pain sensation
2) reaction to pain sensation
what are the three stages of pain
acute, prechronic, and chronic
what is acute pain
normally brief from a cut, burn, injury; adaptive in that it signals the person to avoid further injury
what is prechronic pain
pain that occurs between acute and chronic pain
what is chronic pain
endures over months; no adaptive reason or biological benefit to the pain
what are the types of chronic pain
neuropathic, mixed, and nociceptive
what is neuropathic pain
nerve damage usually described as burning pain or numbness
- can be caused by HIV or diabetes
- most common in feet but can affect a variety of body parts
what is diabetic neuropathy
type of neuropathic pain
60-70% of people with diabetes have some form of neuropathy
-most common in those with diabetes for 25+ years
what is mixed pain
mix of nerve and joint and tissue pain
explain migraine and chronic daily headache
type of mixed pain
- 12% in last year had migraines, 31% miss obligations and 25% went to hospital
- women more likely to experience than men, and has a curvilinear relationship with age (peak is early adulthood)
- more migraine pain at young age, opposite of chronic pain trends
- modifiable migraine triggers are alcohol, exercises, lack of sleep, stress, smoking
- non-modifiable migraine triggers are menstruation and upper respiratory infections
explain fibromyalgia
type of mixed pain
- 2% have it, still a mystery but 80-90% of diagnoses are women
- links to accidents, infection emotional stress, trauma and auto-immune disorders
what is nociceptive pain
body tissue or joint damage
-usually described as sharp
what is arthritis
a type of nociceptive pain
-physiologically based disease that causes erosion of bones near joints or inflammation of tissue surrounding bones and joints
what are the two types of arthritis
inflammatory and osteoarthritis
what is inflammatory arthritis and types
chronic inflammation
rheumatoid arthritis: thought to be auto-immune, involves chronic inflammation of the joints
- more prevalent autoimmune disease
- progressive, becomes more severe overtime and leads to functional limitations
- usually affects multiple joints at same time while OA is isolated to one or two regions
gout: crystal induced arthritis, crystals are deposited in the joints
- more common than RA
what is osteoarthritis
degeneration of body
- much more prevalent than other kinds of arthritis, most common in knee or hip
- cartilage has worn away which causes bone spurs to develop
what is the prevalence of arthritis
increases with age and more common in women at all ages
-also higher in whites and blacks than hispanics
what are the risk factors for arthritis
- while other forms of arthritis are more likely to be idiopathic, genetic or injury related, one proximal cause of gout is diet which can be modified
- those who are obese have a greater risk for the most common forms of arthritis
what are common commorbidities of arthritis
- heart disease
- chronic respiratory conditions
- diabetes
- stroke
what is the Universal Pain Assessment Tool
- self report measure of perceived pain
- rank 1-10 (10 being the worst) smiley faces represent pain levels
- can also use to assess specific system
-pain is subjective so self reports are not always ideal
what are other options of measuring pain
1) observational: can observe how the person is behaving (facial expressions) to try and determine pain severity
- good for those who cannot self report
2) electromyography (EMG): measures level of muscle tension as pain may increase tension
3) heart rate: predicts perception of pain, but only for men
- we are making inferences that the physiological data is an accurate indicator of pain
what is the best method of pain assessment to date
self report chart
what are sex differences in pain perceptions
- women report higher pain in all conditions
- could be because they feel more pain (biological)
- or more comfortable reporting pain (psychological-men should act tough stigma)
what are the race differences in pain perceptions
- black and hispanic americans report higher sensitivity to pain than white americans
- hispanic americans twice as likely to receive no pain meds for bone fracture and blacks 66% likely than whites to receive medication
what determines how pain is treated
how pain is signified by the patient and understood by the provider
what is a study about race and pain perceptions
participant pain ratings were significantly lower for black than white targets
- tests show that these results are not due to implicit or explicit racial bias
- authors indicate that people reporting think black people are inherently tougher because they’ve faced more hardships (seems positive at first but it can cause racial bias and disastrous outcomes like an underestimation of pain)
what are the two types of pain treatment
pain management vs. pain elimination
what is pain management
- most causes of chronic pain involve this
- depends on type of disorder and severity of pain
- could involve therapy and/or medications
- treating the symptoms not the pain itself because the pain cannot be eliminated
what are surgical approaches for pain
- hip/joint replacement (normally for arthritis)
- not always possible for every condition
- damage due to neuropathy could result in limb removal
what is neuropathy pain treatment
- using prescription meds that are primarily used to treat other disorders (antidepressants, anticonvulsants, opioids)
- dont have to be depressed to benefit from these drugs (they can also help with pain)
what are external options for pain treatment
- based on application of heat (infared heat technology and paraffin wax treatment)
- icy hot patches, sprays and creams
what are therapy and exercise options for pain treatment
- PT
- problems
1) have to get patients to look past the short term pain to see the long term benefits
2) need to customize physical activity for each patient to keep motivation high
these types of treatments can be very effective for long-term reduction of pain
what is comorbidity with chronic pain
-anxiety has a high comorbidity rate with chronic pain (arthritis, migraine, back pain, etc) (about half of patients with pain report this comorbidity)
what are psychological interventions to pain treatment
relaxation, behavioral, cognitive and cognitive-behavioral therapy
what are complementary approaches to pain
- people with pain related disorders commonly report use of CAMs
- acupuncture, massage, yoga, etc
- often used with back pain
what are coping and social support strategies to deal with pain
use of engagement
- style of coping is important (problem focused and emotional focused)
- more social support related to less depression, especially for women
what is emotional disclosure
based on the idea that unresolved issues create stressors that have negative health consequences, shown to improve immune functioning and pain
