Week 6 - Pain Flashcards
Definition of Pain?
Associated w/ actual or potential damage
Doesn’t mean there is actual damage
Pain effects us emotionally
The biopsych approach to Pain
Pain is a dynamic and unique interaction for each individual
Transmission of Pain (receptors and transmitting fibers)?
Nociceptors
- free n. endings that respond to them/ therms;/ mechanical stem
- Brain interprets as pain
A-delta neurons in the skin transmit fast pain
C-fibers (neurons) - in superficial and deep tissue - transmit slow pain
Neurotransmitters involved in Pain?
Inhibit or enhance synaptic activity (Pain)
- Substance P (afferent. facilitates)
- Norepinephrine (inhibits pain)
Seratonin (inhibits pain)
Beta- endorphins (CNS, inhibit pain)
Pain during Inflammatory Response Phase?
SHARP
- Nociception (sensation of pain) helps protect body from making injury worse
- Allows clot formation for the FRP to begin
GAte Control Theory for Regulating Ian?
Why rubbing an injury makes it feel better
- A-beta fibers override A-delta and C-fibers = blocked/ closed gate
- Pressure and rubbing activate the A-delta fibers
Regulating Pain - Descending Pathway Pain Control?
Happy Thooughts
- Descending afferent impulses inhibit afferent pain signals
- Past experience, emotional response, and sensory perception all influence the perception of paine
Regulating Pain - Endorphin Release Theory?
Noxious stem can resulting release of Beta-endorphin from Hypothalamus
- Opiate-like affects (inhibit pain)
- Accuuncture, electrical current point stem can cause endorphin release
- Longer term pain relief than Gate-Control Theory
Pain Sensitization?
We can increase our sensitivity to pain
-CNS - normal input from nociceptors causes a large output from CNS
- PNS nociceptors get more sensitive and fire more easily
- Influenced by continuous tissue irritation and other factors like stress, sleep, anxiety
Unhelpful Pain Coping Strategies?
Avoidance of activities to avoid pain
Persistance - continue in activity despite pain
FIND A BALANCE
Pain CAtasrtophizing?
tendency to magnify the threat value of a pain stimulus and to feel helpless in the context of pain
Strategie to deal w/ pain sensitization?
Education
Gradual exposure to scary movement
Set small goals and celebrate achievements
The overflowing cup of pain?
Decrease stressors that sensitize or contribute to pain
Build up tolerance to our pain threshold
Pain Habituation?`
Same sensory input leads to smaller output
- Use in REHAb context
- start doing meaningful things even w/ a little pain
Modify mvm or speed slightly
- Form positive association w/ those moms
- Don’t need to fix everything to start
-
Load Management?
Avoid too much too soon
- Find balance b/w progressive overload and loading that increases pain sensitization
- No activity is off limit forever
Exercise prescription in presence of pain?
Goal = keep athlete moving / tolerable amount of Ian
Pain changes from day to day
After exercise, monitor for 24-48 hrs to determine whether to increase activity
USE RPE and #/10 pain scale
Pain during vs pain after exercise
Patient-Provider communication amidst pain
Use effective questioning
Express empathy and concern
Share the decision making
address challenges –> language, culture, pain beliefs etc.
