The Psychology Of Pain

Question 0

Noiceptive pain

Answer 0

Arthropathies
Myalgia
Skin and mucosal ulcerations 
Non articuler inflammatory  disorders 
Visceral pain

Question 1

Types of pain

Answer 1

Organic-> pain clearly linked to tissue damage
Psychogenic-> no observable physical cause-> discomfort seems to originate from psychological factors -> chronic pain disorder
Acute-> lasts less than sixth months-> high anxiety that subsides
Chronic-> more than sixth mons-> anxiety persists-> helplessness and hopelessness, interferes with daily activity
Recurrent-> benign cause-> repeated intense episodes separated by no pain
Intractable-> begin cause->constant discomfort, variable intensity
Progressive-> malignant cause-> increasingly intense

Question 2

Neuropathic pain

Answer 2

Post herpectic neuralgia
Trigeminal neuralgia
Diabetic poly neuropathy
Post stroke
Post amputation 
Causalgial like syndrome-> complex regional pain

Question 3

Mixed/unknown pain

Answer 3

Chronic recurrent headaches

Vasculopathic pain syndromes

Question 4

Psychologically based pain syndromes

Answer 4

Somatisation disorders

Hysterical reactions

Question 5

Pain without detectable body damage

Answer 5

Persists long after healing
May spread or increase in intensity
May become stronger than initial pain from the injury

Question 6

Neuralgia

Answer 6

Very painful
Shooting/stabbing pain along the course of a nerve
Sudden, provoked by innocuous stimuli
-> trigeminal neuralgia

Question 7

Causalgial

Answer 7

Recurrent severe burning pain

Originates from a region with earlier injury

Question 8

Hyperalgesia

Answer 8

Intensified perception of mild painful stimulus

Question 9

Allodynia

Answer 9

Perception of pain in response to the lightest a of touched, even spontaneous pain

Question 10

Phantom limb pain

Answer 10

90-98% of amputees experience this
Similar pain to original injury
Or pain at body parts next to amputated limb on somatosensory map

Question 11

Gated control theory

Answer 11

Filtering of noxious stimulation/modulation of incoming pain signals before they reach the CNS
Includes psychological modulation of pain
Believed to be the substantia gelatnosa
Open-> transmission reaches transmission cells-> relayed to brain-> feel pain when they reach the threshold
Level of signal from transmission cells is determined by the extent to which the gate is open
Signal from brain determines how open the gate is

Question 12

Conditions which open the gate

Answer 12

Physical-> extent of injury, inappropriate activity levels
Emotional-> anxiety or worry, tension, depression
Mental conditions-> focusing on pain, boredom

Question 13

Conditions which close the gate

Answer 13

Physical-> medications, counter stimulation
Emotional-> positive emotions, relaxation, rest
Mental-> intense concentration or distraction, involvement and interest in life activities

Question 14

Sensory-discriminative component of pain

Answer 14

3 rapid conduction systems 
-> neospinothalamic
-> spinocervical
-> post synaptic neurones in dorsal column 
Location, intensity and quality

Question 15

Motivational-affective dimension of pain

Answer 15

Reticular formation and limbic system

-> unpleasantness of pain

Question 16

Cognitive-evaluative

Answer 16

Cultural values, attention, suggestion-> change the pain experience
Subverted in part by cortical process-> frontal lobes

Question 17

Perception of pain

Answer 17

Conscious perception of pain only occurs when impulses reach thalmocortical level
Threshold the same in everyone
Lowered by inflammation and raised in anaesthetics, lesions and centrally acting anagesics

Question 18

Cognitive behaviour therapy for pain

Answer 18

Direct and indirect negative reinforcement of pain behaviour
-> positive reinforcement of well behaviour
Physical fitness and function
Education
Coping mechanisms

Question 19

Other pain therapies

Answer 19

Operant approach-> extinction of pain behaviour by reinforcement of appropriate behaviour
Relaxation and biofeedback-> headaches
Hypnosis-> variable with suggestibility
Acupuncture-> may close spinal gate, reduced anxiety from beside it will work, endorphin release