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KINE2495: Introduction To Sport Related Injuries > Topic 4: Pain: Introduction to the Physiological and Psycological Aspects of Pain > Flashcards

Topic 4: Pain: Introduction to the Physiological and Psycological Aspects of Pain Flashcards

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1
Q

What is pain?

A

a subjective and multidimensional, unpleasant sensory and emotional experience associated with actual or potential tissue damage

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2
Q

Is there a purpose behind pain?

A

Yes. There is a reason we experience it. It vital to our ability to survive.
- here to protect us and tell us that something is wrong

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3
Q

Two types of pain

A

Acute and chronic

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4
Q

What would happen if we couldn’t feel pain?

A

we wouldn’t be able to tell if something is progressing or getting worse

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5
Q

What is acute pain?

A

the pain that is more immediate

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6
Q

What is chronic pain?

A

the pain that usually lasts longer than three months. Somethings can last years.
- long periods of pain can affect someone physically and emotionally

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7
Q

What are the categories of pain?

A
  • somatic (tissue) pain
  • visceral (tissue) pain
  • psychological pain
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8
Q

What is somatic tissue pain?

A
  • pain that originates from the skin and from the musculoskeletal system
  • ligaments, tendons, bones, joints and muscles
  • typically localized to a very specific or particular problem site
  • related to particular injury or movement, so they will usually remember where its from
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9
Q

what is visceral pain?

A
  • pain that specifically originates from the internal organs
  • can cause referred pain
  • pain that’s harder to pinpoint
  • person is quite nauseous if they are experiencing this pain
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10
Q

what does it mean when pain is referred?

A
  • it causes pain somewhere else in the body
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11
Q

what is psychological pain?

A
  • when we feel the sensation of pain but there is not apparent physical cause of that pain
  • no physical cause or damage
  • emotional based
  • ex. feeling pain where you are emotionally upset
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12
Q

When is pain felt?

A

when there is a stimulation of our afferents or sensory nerve endings and specifically when there is a stimulation of our pain receptors (nociceptors)

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13
Q

What is a nociceptor?

A

a afferent or sensory nerve endings that when they are stimulated are going to produce a pain sensation.
- A PAIN IMPULSE THAT WILL GET TO OUR BRAIN

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14
Q

Three subcategories of nociceptors?

A
  • mechanosensitive nociceptor
  • thermosensitive nociceptor
  • chemosensitive nociceptor
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15
Q

What is a mechanosensitive nociceptors?

A
  • responding to touch or pressure
  • overstress or compress a tissue (toe stepped on)
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16
Q

what is the thermosensitive nocioceptors

A
  • responding to extreme heat or cold
  • ex. touching a hot stove
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17
Q

what is the chemosensitive nociceptors?

A
  • responding to chemicals
  • ex. serotonin or inflammation process chemicals
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18
Q

What are the categories of pain?

A
  • referred pain (areas away from injured tissue feel pain)
  • radiating pain (pain is felt along an involved structure)
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19
Q

What causes a referred pain?

A

When there is a mix up of messages. Too many afferent nerve signals try to signal at the same time.

OVERCONVERGENCE

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20
Q

why ask to describe the pain?

A

to find out what tissue might be involved

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21
Q

What might it mean if someone says they have ‘shooting’ pain

A
  • nerve pain
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22
Q

What might it mean if someone says they have ‘throbbing’ pain

A
  • source might be congestion in joint.
  • swelling or fluid build up
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23
Q

What might it mean if someone says they have ‘stabbing’ pain

A
  • acute injury (immediate)
  • ligament or muscle strain
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24
Q

What might it mean if someone says they have ‘deep’ pain

A
  • can be more bone related (arthritis)
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25
Q

What might it mean if someone says they have ‘stiff’ or ‘achy’ pain

A
  • chronic inflammation
  • muscle or tendon or joint injuries
25
Q

What does morning stiffness that gets better with activity mean?

A

chronic inflammation with swelling
- ex. arthritis

25
Q

what does pain increasing as day progresses mean?

A

increased congestion in a joint

26
Q

what does sharp, stabbing pain during activity mean?

A

acute ligament sprain or muscular strain

27
Q

what does dull, aching pain aggravated by muscle contraction mean?

A

chronic muscle strain

28
Q

what does pain that subsides during activity mean?

A

chronic inflammation

29
Q

what does night pain mean?

A

compression of a nerve or bursa
- also associated with cancer pathologies

30
Q

what does deep/nagging/very localized pain mean?

A

bone pain

31
Q

what does sharp/burning/numbness pain mean?

A

nerve pain

32
Q

what does general aching / referred to another area pain mean?

A

vascular pain

33
Q

What is the acronym to remember what types of questions and what does it mean?

A

OPQRST

Onset (sudden vs gradual)
Provoke (what makes it better or worse)
Quality (describe what it feels like)
Radiate or refer
Severity (0-10)
Timing (when did it start)

34
Q

What is the physiology of pain?

A
  • noxious stimuli. pricked in the finger, going to stimulate a somatic nociceptor, a mechanosenstive nociceptor.
  • pain travels through an afferent nerve ending as what we call an impulse.
  • will travel along a primary neuron (first order neuron)
  • will hit the spinal cord and an exchange will happen
  • at spinal cord. there is a neurotransmitter thats going to pick up the message and then transport it through a second order neuron
  • synapse occurs there
  • it will travel up the spinal cord through the ascending tracts until it reaches the brain and a specific part of the brain called the thalamus when there is a sensory relay station.
  • potentionally go to other parts of the brain in the cerebral cortex where it will get registered as pain
  • brain registers action is necessary and body needs to react
  • message will them travel back down the spinal cord through the descending tracts and back to the area pricked
35
Q

what is a noxious stimulus?

A

any stimulus that going to elicit a pain response

36
Q

what is the pain pathway?

A

nociceptor –> first order neuron–> spinal cord -DL tract (substantia gelatinose) –> second order neuron –> thalamus –> third order neuron –> cerebral cortex

37
Q

What happens if pain goes to the limbic system?

A

it could alter your mood and attention

37
Q

How pain gets interrupted

A
  • it wont gets to the point where it is registered as pain. (ex. stops in the spinal cord so IT CANNOT GET TO THE SECOND NEURON)
    (ex.2: epidural)
37
Q

What is Group II of afferent nerves?

A

Group II: AB (A beta) fibers
- an afferent nerve ending with a myelin sheath around it. better nerve transmission (largest diameter) (doesn’t take much to trigger impulse) (pain travels the fastest here. 35-75m/sec)
ex. temperature, pressure and touch impulses

38
Q

What is Group III of afferent nerves?

A

Group III: A8 (A delta) fibers
- large diameter, thinly myelinated (signal doesn’t travel as fast as AB because of this), 5-30m/sec
ex. carry pain messages that get activated first and start that message going to the brain

39
Q

What is group IV of afferent nerves?

A

Group IV: C fibers
- chronic pain that happens after (travels along these fibers)
- no myelin (slowest rate)
- 0.5-2m/sec
- ex. transmits lower levels of pain like dull and aching (diffuse) types of pain (the ones that linger)

40
Q

what is coping with pain?

A

the ability to identify, manage and overcome issues that stress us in any capacity. might be dependent on what is threatening to you specifically

41
Q

what does coping need to do?

A

reduce the threat value. any sort of stimulus and the associated emotions or the tissue change

42
Q

will you feel more pain if your brain thinks you are in danger?

A

yes

43
Q

pain comes from a lot of our brains ability to determine the ___________________________________________.

A

threat value surrounding the situation

44
Q

why do kids overreact when in pain?

A

their body is not used to it so their brain thinks they are in big danger. the pain felt is more psychological than physical

45
Q

what are some factors that can influence a person’s perception of pain?

A
  • physical
  • psychosocial
  • cognitive
  • belief systems
  • distraction
  • past experiences
  • peer pressure “suck it up”
  • ethnic background
46
Q

what are the three primary theories around pain control?

A
  1. gate control theory
  2. descending pain control (central biasing)
  3. B-Endorphin theory
47
Q

what is the gate control theory?

A
  • we have the ability to block pain at the spinal cord level.
  • blocks the AB fibers
    ex. stubbing your toe and grabbing it (putting pressure on it to block pain) or putting ice
  • stimulating touch receptors which travel along AB fibers so they reach the brain faster.

short answer: non painful stimuli can block painful stimuli (nonpainful travels faster)

48
Q

what is the descending pain control theory?

A
  • we have the ability to consciously override pain
  • ex. if someone believes a medication is going to relieve the pain, it is psychological and will relieve their pain. (placebo effect)
  • 60% of our brain power alone can control pain through the placebo affectwa
49
Q

what do enkephalins do in the descending control?

A

they block the release of substance P by binding to it

50
Q

what is substance P?

A

neurotransmitter tat carries the pain message across the synaptic cleft

51
Q

what is the B-Endorphin theory?

A
  • noxious (painful) stimuli of nociceptors resulting in the transmission of pain information along Ad and C afferents can stimulate the release of an endogenous opiate-like chemical called B-endorphin from hypothalamus.
  • body’s natural pain killers
  • can be stimulated from things like acupuncture
    ex. runners high
52
Q

what is the most important factor in learning how to cope with pain?

A

gaining a sense of control over pain

53
Q

psychological pain factors

A
  • previous pain experience
  • pain expectations
  • pain tolerance levels
  • effect of modalities (what a pill looks like allows it to be more effective)
  • body part/what the injury looks like
  • situation/time of reason/winning/losing
  • status of player
54
Q

why is acute pain important?

A

it is the pain that protects us from further harm

55
Q

how to handle acute pain situations as an AT

A
  • establish control
  • establish helping / collaborative relationship between you and the athlete
  • establish cooperation with the athlete
  • alter the concentration (distraction/attention)
  • provide information
  • caveat - adrenaline may mask pain
56
Q

psychological techniques to cope with pain

A
  • maintaining a sense of humour
  • patient / pain education
  • distraction / attention
  • visualizations (pain modalities)
  • goal setting (reduce swelling to reduce pain)
  • relaxation skills
57
Q

can depression result from chronic or acute pain more commonly?

A

chronic

58
Q

key concepts of pain

A
  • KNOW pain or NO pain
  • knowledge is a powerful combative to pain
  • knowledge is the great pain liberator
  • keep on moving

KINE2495: Introduction To Sport Related Injuries (18 decks)

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