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APM- Pain > The puzzle of pain > Flashcards

The puzzle of pain Flashcards

1
Q

Define pain

A

An unpleasant SENSORY AND EMOTIONAL experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

What is the most common cause of dental pain?

A

Tooth ache

Chronic dental pain

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3
Q

What can heighten the pain response?

A 
Anxiety
Depression
Mood 
Previous bad experiences 
Genetics 
Neurochemical and structural changes
Sensitisation
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4
Q

How does the biomedical framework describe pain?

A

Describes Pain as an automatic response to an external factor
Tissue damage causes the sensation of pain
The pain sensation has a single cause
Psychological factors have no causal influence

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5
Q

In the biomedical framework what was organic pain?

A

regarded as “real pain” when some clear injury could be seen

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6
Q

In the biomedical framework what was Psychogenic pain?

A

“all in the mind” when no organic basis could be found

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7
Q

How did Melzack & Wall define pain?

A

As an aversive, personal, subjective experience, influenced by cultural learning, the meaning of the situation, attention and other psychological variables, which disrupts ongoing behaviour and motivates the individual to attempt to stop the pain

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8
Q

How did Broome & Llewelyn define pain?

A

There is now compelling evidence that cognitive, motivational, judgemental and psychologic processes … from learning, personality, past experience, culture and conditioning among other factors influence the transmission of nociceptive impulses at the very first synapse and at all subsequent levels

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9
Q

How did Crossley define pain?

A

His body, taken over by pain, comes to have agency. ‘It is a demon, a monster … Pain is an “it”’. In this way, severe pain and illness leads the individual to lose their ‘normal occupancy of everyday reality, producing ‘alienation’ and an ‘existential vacuum’ in which s/he feels ‘cut off from the outer world’, isolated and disintegrating.

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10
Q

How did McCaffrey define pain?

A

“Pain is whatever the experiencing person says it is, existing whenever he/she says it does”

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11
Q

Why do we have pain?

A

It provides constant feedback about the body enabling us to make adjustments to how we sit or sleep or eat
It is essentially a defence mechanism
A warning sign that something is wrong resulting in protective behaviour
It triggers help-seeking behaviour
It has psychological consequences and can generate fear and anxiety

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12
Q

What is a key way of managing pain?

A

Creating a distraction

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13
Q

What are the 2 types of pain?

A

Acute

Chronic

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14
Q

Define acute pain

A

Adaptive and meaningful pain from cuts, burns, surgery and other injuries

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15
Q

Define chronic pain

A

When enough time for normal healing has lapsed (3mths) but the pain has not subsided. Often without any observable damage

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16
Q

Describe some features of acute pain

A 
A warning system
Represents tissue damage
Message – do something about this!
Short duration
Care and relief likely
Suffering recognised
17
Q

Describe some features of chronic pain

A

May or may not be associated with tissue damage – pain itself is disease
Long duration
No end in sight
Care and relief not likely
‘Psychosomatic’
Suffering may be dismissed – it’s all in your head!

18
Q

Is pain only induced physically?

A

No it can be phycologically induced or even imaginery

19
Q

Are medical treatments used to treat pain effective for chronic pain?

A

No they are usually only effective again acute pain

20
Q

How many amputees suffer from phantom limb pain?

A

65% - 85%

21
Q

Name the theory Melzack & Wall introduced in 1965

A

The gate control theory

22
Q

Describe the gate control theory

A

There is a neural “gate” in the spinal cord that regulates the experience of pain
Pain is not the result of a straight-through sensory channel
There are both physiological and psychological causes
Pain is a perception and experience rather than a sensation
The individual no longer just responds passively to painful stimuli but actively interprets and appraises the stimuli

23
Q

What information is sent to the gates in the gate control theory?

A 
Behavioural state (e.g. attention, focus on the source of pain)
Emotional state (e.g. anxiety, fear, depression)
Previous experience or self-efficacy in dealing with the
24
Q

What do large diameter nerve fibres sense?

A

Sensation of pressure

25
Q

What can we do to block the pain experience?

A

Massage the area so that the mechanoreceptors are stimulated

26
Q

What does the gate control theory say?

A

Pain is the result of the relative activity in large and small diameter nerve fibres

27
Q

What does the gate control theory say large fibres do?

A

They carry sensory information and close the gates which inhibits the flow of information

28
Q

What does the gate control theory say small fibres do?

A

Carry noxious information and open the gates to facilitate the flow of information

29
Q

Where does the descending inhibitory pathway come from?

A

Your limbic system that controls your emotions

30
Q

Why does a well functioning psychologically functioning patient not experience pain?

A

Because their descending pathways inhibits the pain response

31
Q

Why might an anxious patient experience pain?

A

Because their descending pathway is impaired

32
Q

Describe some informal techniques we can use to control pain

A 
Avoid negatives
‘Reframing’ sensation
NEVER say you won’t feel anything!
Relaxation and lowered pain threshold
Distraction
Massage the area – chronic pain
Apply pressure or stretch mucosa prior to injection
33
Q

What does Lautch’s research say

A

He says the phycological factors work together with your pain amplification states and environmental factors to produce pain

34
Q

What are some chronic oro facial pain?

A

TMJ pain (facial arthromyalgia) – most common
Atypical facial pain (PIFP)
Burning mouth syndrome
Atypical odontalgia (PDAP)

35
Q

What mnemonic do we use to make a pain diagnosis?

A

SOCRATES

36
Q

What does SOCRATES stand for?

A 
Site 
Onset 
Character 
Radiation
Association 
Time course 
Exacerbating/Relieving factors
Severity
37
Q

what are the components affect the pain experience?

A 
Sensory-discriminative
Neurophysiological/biochemical
Motivational-affective
Behavioural
Lifestyle impact
Information processing

APM- Pain (2 decks)

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