Week 5 Pain Science Flashcards
T/F Pain = Tissue Damage.
False
What is fear of movement because of the potential of pain called?
Kinesiophobia
What nerve fibers are in the eyes?
Light receptors
What nerve fibers are in the ears?
Vibration receptors
What type of nerve fibers are in our tissues?
Nociceptive or “danger” receptors
How do you define pain?
A multiple system output, activated by the brain based on perceived threat
What afferent neuron is for non-noxious mechanical stimulus?
A-beta
What afferent neuron is for noxious mechanical stimulus?
A-delta fiber
What afferent neuron is for noxious heat and chemical stimuli?
C fiber
When you have a fight or flight response, you get a surge of _____ and _____.
Adrenaline and Cortisol
When you have a physical response to threat, what 4 things increase? what things decrease?
Increase: HR, respiration, BP, muscle tone
Decrease: Digestion, sexual function, other non-essential functions
T/F: The fight or flight response is designed to be long term.
False
When the threat is gone, system returns to normal. The system is designed to be short term
What is it called when your body accumulates stress?
Allostatic Overload
What part of the body releases adrenaline?
Adrenal Medulla
How can cortisol affect tissues?
sore, tired, sensitive, fatigued
How can cortisol affect the brain?
Memory, sleep, concentration, BP, reproduction
How does cortisol affect the immune system?
Cytokine signaling, increased nerve sensitivity, persistent inflammation, brain plasticity
What is the Cartesian Model Though Process?
- Pain = tissue damage
- I hurt, therefore, I must be injured
- More pain = more damage
- Movement -> Pain
- Movement -> Injury
KINESIOPHOBIA!
How can we break the cycle?
Teach patients to avoid dwelling and catastrophizing
How patients react to pain experience can affect recovery
What is the fear avoidance model?
Pain can lead to catastrophizing
* be careful of your language with pt education
* pain will cause some of your pts to pull away from activities and participation
* Depression -> disability
About what ratio of patients with chronic pain don’t have an injury?
1/3
With the fear avoidance model, how can we help patients?
Educate the patient about their pain
* Confront their pain with knowledge!
What is pain catastrophizing?
Inability to foresee anything other than the worst possible outcome OR experiencing a situation as unbearable or impossible when its just uncomfortable
irrational thoughts AND limited knowledge
What are some things that can negatively affect pain/illness?
- Threatening and provocative words
- Medical tests
- Various opinions
- Internet
- Past experiences
What are impaired beliefs?
Patient feels afraid, poorly understood, and thinks that mvmt causes pain and that their tissues are being damaged
- Fear —> high threat
How is pain useful?
- Alerts us to injury or danger
- Protects the body
- Why we’re still here as a species
What is MI?
Motivation Interviewing: collaborative conversation style for strengthening a person’s own motivation and commitment to change
What are the 8 communication themes?
- Disclosure-facilitating
- Rapport-building
- Empathic
- Collaborative
- Professional Accountability
- Informative
- Agenda-setting
- Meta-communication
What are the core skills for MI?
- Open-ended questions: allow pts to express themselves
- Affirmation: “Thats a good strategy…”
- Reflections: repeating, paraphrasing, seeking confirmation
- Summaries: of pt story; do they consider change?
