Week 1: History & Models Flashcards
Before the main pain models were formed who were the four main contributors prior?
HAGA
- Hippocrates
- Aristotle
- Galen
- Avicenna
What did Hippocrates believe?
Pain was a result of imbalances in the vital fluids. The heart was considered the centre of pain
H = heart & I = imbalances
What did Aristotle believe?
Pain was due to evil spirits which entered the body via an injury. Pain was an emotion.
E = evil spirits & emotion!
What did Galen believe?
The brain was the organ of feeling. Placed pain into the sphere of sensation.
What did Avicenna believe?
Pain can dissociate from touch or temperature recognition. Proposed pain to be an independent sensation.
What did Rene Descartes compare the body to?
How did he view pain?
The body was more similar to a machine. Pain was transmitted via hollow tubes to the brain
- Stimuli exposure ie foot in fire (heat)
- Gate between the brain and rest of nervous system opens due to exposure to a sensory cue (ie the heat of the fire)
- The flame activates the nerve fibre which carries that information up the leg to the spinal cord to the brain (via animal spirits)
- Motor response to the pain message (ie foot removed from fire)
What were the two key issues with Descartes view of pain?
Dualism: mind is separate from the body. Descartes attributed pain perception to the minds interpretation of sensory signals
What is the specificity of pain theory?
What is the pattern response theory?
Pain results from activation of pain receptors, transmitting signals directly to the brain via specific pathways
The stimulus intensity and the processing of the pattern of responses determines the perceptual response to the nociceptive input, namely pain
Which two theory’s explain the biomedical model of pain?
- The specificity of pain theory
- The pattern response theory
Who proposed the definition of pain causing stimuli as tissue-damaging (noxious)
Sherrington (1906)
Under the biomedial model of pain, what did Woodworth & Sherrington propose?
The brain and spinal cord is necessary to experience pain. In particular without the essential contribution of the cortex, normal pain responses fail to occur during noxious stimulation of the peripheral nerves.
What contradicted the biomedial view of pain?
Beecher (1946) - studied soldiers and found some had terrible injuries yet many (32%) had no pain! Proved that pain doesn’t correlate well to the level of tissue damage.
Also proven in the person who had a 15cm nail go up his boot and was in severe pain yet it appeared to have pierced his boot in between the toes.
Another study found that pathology didn’t equal pain. 5000 x-rays of the knee. Of those severe OA 25% didn’t report pain.
