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Clinical Medicine - OT > Week 9 - Chronic pain > Flashcards

Week 9 - Chronic pain Flashcards

1
Q

What is chronic pain?

A

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

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2
Q

What are the key concepts of pain?

A 
Pain is an output
Pain is subjective
Pain is influenced by many factors
Pain is protective
Pain is essential
Pain is not always an indicator of tissue damage
Hurt does not equal harm
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3
Q

What is acute pain?

A

Lasts for a few weeks or months, often caused by tissue damage eg back injury, or ankle sprain. It is a normal, protective response from the body

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4
Q

What is chronic pain?

A

Pain that lasts 3 months or longer. Tissue damage is often not the main issue.

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5
Q

Why does complex pain occur?

A

Pain going on for longer than 6 months is less about the injury and more about over sensitivity so the brain keeps producing pain responses

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6
Q

What 5 things need to be considered for chronic pain?

A
  1. Medical options
  2. Thoughts/emotions
  3. Diet/Lifestyle
  4. Personal History
  5. Physical activity and function
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7
Q

What does chronic mean?

A

Any condition that has a protracted clinical course, usually longer than 6 months

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8
Q

What are the 3 types of pain?

A
  1. Nociceptive pain
  2. Neuropathic pain
  3. Nociplastic pain
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9
Q

What is Nociceptive pain?

A

The sensory nervous system’s way of transmitting noxious stimuli. It is pain projected into damaged body parts or referred pain

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10
Q

What is Neuropathic pain?

A

Pain that is caused by damage, injury or dysfunction to the nervous system. It is secondary due to trauma, surgery, chemotherapy or disease,

Neuropathic pain is associated with neurological symptoms:

  • burning pain
  • pins and needles
  • numbness
  • weakness/clumsiness
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11
Q

What is Nociplastic pain?

A

Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain.

It is pain where there isn’t nociception or neuropathic dysfunction.

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12
Q

Who is most likely to have chronic pain?

A

Females and older people

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13
Q

How do psychological factors affect chronic pain?

A

Affects pain perception and can contribute to the complexity of the individual’s presentation. It can help guide both the treatment approach and identification of goals with the patient

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14
Q

True or false, psychological and social factors influence outcomes of chronic pain?

A

True

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15
Q

What is persistent pain?

A

Long lasting
Persistent warning
complex and confusing
Pain will last long beyond normal time frames

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16
Q

What is acute pain?

A 
Short term
Warning system
Natural process
Predictable
Pain follows expected healing timeframes
17
Q

What are the symptoms of persistent pain?

A 
Tingling
Sharp
Throbbing
Burning
Shooting 
Radiating
18
Q

What are cytokines?

A

Any of various protein molecules secreted by cells of the immune system that serve to regulate the immune system.

19
Q

What are neutrophils?

A

The chief phagocytic leukocyte

20
Q

What are B & T cells?

A

Types of lymphocytes

21
Q

What are leukocytes?

A

Blood cells that engulf and digest bacteria and fungi; an important part of the body’s defence system

22
Q

What are DRG neurons?

A

‘Dorsal Root Ganglia’ - a cluster of nerve cells located where the peripheral nerves join the spinal cord. They act as a relay station for the transmission of pain signals from the periphery to the CNS

23
Q

What are macrophages?

A

A large phagocyte, some are fixed, others circulate in the blood stream

24
Q

What are the signs of persistent pain?

A 
No visible signs on imaging
Sometimes the individual is protective of the body part
Some conditions have physical signs:
Colour change
Oedema
Muscle atrophy
Hotness
Changes in sensitivity
Allodynia
Hyperalgesia
25
Q

What conditions can be seen for pain management?

A 
Low back/neck injuries/MVA
Degenerative conditions - OA
Chronic regional pain syndrome
Diabetic neuropathy
Fibromyalgia
Phantom limb pain
Spinal stenosis
26
Q

What is the impact of persistent pain?

A 
Physical capacity
Psychological wellbeing/mood
Sleep
Relationships
Work
Finances
27
Q

What is the persistent pain cycle?

A

Pain > Rest > Become stiffer > Movement is more painful > Move less > Lose fitness > Movement is even more painful > pain

28
Q

What is the pharmacological management of chronic pain?

A 
Procedural pharmacology such as:
Epidural
Sacro Iliac Joint injections
Facet joint injections
Ablations
Spinal cord stimulator
29
Q

What psychological intervention can assist with chronic pain?

A

Assessment of mood, beliefs, coping skills, family support & expectations regarding pain management
Stress management
Relaxation
CBT

Clinical Medicine - OT (35 decks)

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