Module 01 Introducing Pain Management Flashcards
What pain is short-lived and resolves when the painful stimulus is removed?
How long is it present for?
Acute pain
Examples include a cut, bruise, burn, broken bone, or pulled muscle,
Caused by injury, surgery, illness, trauma or painful medical procedures
Present for less than 3 months.
What pain persists beyond the expected time of healing or for longer than 3 months?
What can be a response from removing the stimuli to pain?
Chronic pain
This occurs because the nervous system has become damaged or altered.
The messages that the pain sends, to rest or immobilize the painful area, can be counterproductive and lead to loss of function with significant long-term health and socio-economic impacts.
Describe the structure of the bio-psychosocial model of pain and the impact on quality of life.
Within the biological, psychological and social functions.
What kind of pain is Nociceptive pain?
Nociception is the body’s ability to detect a painful stimulus.
Specialist nerve endings called nociceptors are found throughout the body, responding to different painful stimuli by causing a nerve impulse that travels via the peripheral nervous system to the spinal cord and brain.
Protecting against injury
What kind of pain is Neuropathic pain?
Pain arising from damaged nerves.
Neuropathic pain serves no protective function and is often out of proportion to the original injury.
Pain from a malfunction in the nervous system itself, for example, nerve damage following surgery or trauma, exposure of nerves to toxins such as alcohol or high blood sugars.
What kind of pain is Nociplastic pain?
Pain that occurs despite an absence of any obvious tissue or nerve damage.
How is Nociceptive pain typically described?
Nociceptive pain is typically described as a sharp pain or a dull ache, the degree of pain is usually proportional to the cause.
A patient is usually able to describe their pain quite easily.
How is Neuropathic pain typically described?
Neuropathic pain can be difficult to describe and sufferers may use terms such as burning, shooting, crawling, electric shocks or stabbing. There may also be sensory changes such as numbness or hypersensitivity.
The patient may be unable to say exactly where it is, or what it feels like and it may appear to be out of proportion to the cause.
what does Nociceptive pain respond best to?
It is likely to respond to simple analgesics such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDS).
what does Neuropathic pain respond best to?
It is likely to respond best to antineuropathic medications such as tricyclic antidepressants (amitriptyline) or gabapentinoids (pregabalin or gabapentin).
what does Nociplastic pain respond best to?
If the pain is nociplastic, non-pharmacological treatments are the preferred first step, with patient education and psychological therapies.
Antineuropathic medications can be trialled, such as tricyclic antidepressants or gabapentinoids.
What 8 questions should you ask to establish the patient’s history?
- How long has the patient felt this pain?
- What caused the pain, for example trauma, surgery, diabetes?
- Where is the pain?
- What makes it better or worse?
- Is it better or worse at any particular time of day or night?
- Does it come and go?
- Does it vary with position?
- What is the character of the pain (what does it feel like)?
