Types of Pain

Question 1

Definition of pain

Answer 1

Unpleasant sensory, emotional experience associated with actual/potential tissue damage
-invisible and unique to the individual

Can have a combination of different types of pain => important that we use a variety of approaches to manage it

Question 2

Types of pain experienced

Answer 2

Acute - short term
-trauma, fractures
-procedural, postop pain
-short term medical conditions
V responsible to NSAIDs, opioids
Has a protective function

Chronic - long term
-back 
-phantom limb
-trigeminal, postherpetic 
-chronic postop pain
No protective function
Difficult to manage

Cancer related pain

• symptoms prediagnosis
• investigations, diagnostic techniques
• treatment-related
• palliative care symptoms
• pressure ulcers, lymphedema

Question 3

Types of pain by mechanism

Answer 3

Nociception - processes involved in processing noxious stimuli

Nociceptive/inflammatory pain - tissue damage
Neuropathic pain - somatosensory nerve damage
Nociplastic pain - no identifiable tissue/nerve damage
-fibromyalgia, IBS, tension headache

Question 4

Types of pain by location

Answer 4

Somatic - well localised, sharp, throbbing, aching, dull
-MSK, skin, joints

VIsceral - poorly localised, diffuse, pressure, cramping

• internal organs
• referred pain

Question 5

Epidemiology of pain

• gender
• sites
• chronic, persistent
• cancer
• postop
• residential care

Answer 5

Gender - higher in women

Most common sites - hips, knees, back

Chronic pain - increases with age

Cancer pain - moderate to severe pain is very common
-majority experience pain during treatment

Postop pain intensity found to be similar across age groups but older adults less likely to report it and receive fewer analgesics

Residential care - chronic pain is the most common but do not always receive analgesia

Question 6

Impacts of acute pain

Answer 6

Contributes to stress/SNS response

CV - decreased myocardial flow => arrythmias, MI
Resp - decreased deep breathing, secretion clearing => lung collapse, infections
GI - reduced absorption, bacterial overgrowth, N+V, stasis
Increased pressure ulcer, DVT risk from reduced mobility, oral intake

Risk of developing chronic postop and long term chronic pain

Question 7

Impacts of chronic pain

Answer 7

Affects sleeping, social activities

Increased risk of depression, suicidal thoughts