pain Flashcards
what is the definition of pain?
an unpleasant sensory and emotional experience associated with actual or potential tissue damage
define acute pain
a useful biological response provoked by injury or disease, which is of limited duration
responses are usually adaptive
define chronic pain
pain persisting for 6 months or more and tends not to respond well to pharmacological treatment
Briefly describe the gate control theory (background) of pain
- mechanism in the dorsal horn of the spinal cord
-pain signals carried by nociceptors to the brain to be processed
-pain signals can either be let through or restricted - ie the gate can be opened or closed - open gate - pain signals sent through and pain is perceived
-closed gate - pain signal is restricted
what area specifically in the dorsal horn is the pain gate mechanism located?
the substantial gelatinosa
Describe the 3 primary neutron types involved in the pain gate theory? (myelination? diameter? speed of impulse?)
- A beta fibres - large diameter, have quick transmission of impulses due to myelination
-A delta fibres- smaller fibre diameter, thinly myelinated
-C fibres - similar to A delta fibres, slowest transmission of impulse since they are not myelinated
what stimuli activate the 3 primary neuron’s?
-A beta fibres - non noxious stimuli eg light touch, pressure and hair mvt
- A delta fibres - strong noxious stimuli eg pain and temperature, sharp intense sensations related to potential or actual damage to tissues
-C fibres - carry info about dull, throbbing pain, prolonged sensations
how does anxiety and depression affect pain?
-decrease pain tolerance
- increasing reports of pain
what is the anti pain fibre?
the A beta fibres - they are activated through rubbing, massage and heat and they act to inhibit the perception of pain
what are examples of pain assessment?
- verbal rating scales - using words ranked in order of severity
-visual analogue scale
-Mcgill pain questionnaire consists of 20 descriptor scales
what are the modern aims of pain management?
- reduce pain perception
-improve coping ability
-increase functional ability
-decrease drug reliance & distress
how does attention / focusing on pain affect the pain experience ?
focusing on pain increases the experience of pain
how do we manage acute pain? first line vs second line
1st line - generally pharmalogical
2nd line - psychological intervention - hypnosis, increasing patient control, distraction, relaxation
what are the 5 D’s that can happen as a result of people experiencing chronic pain?
-Dramatisation of complaints
-disuse through inactivity
-drug misuse through over medicating
-dependency on others
-disability due to inactivity
