Psychological perspective on pain

Question 1

What is pain? (textbook definition)

Answer 1

An unpleasant //sensory and emotional //experience associated with, or resembling that associated with, actual or potential tissue damage
note there’s multiple aspects////

Question 2

Difference between pain and nociception?

Answer 2

Yes, they are different
pain cannot be inferred solely from activity of sensory neurons
Pain is often not proportional to damage
‘pain is a decision made by our brain’

Question 3

What does this lecture want to communicate?

Answer 3

ALL PAIN IS REAL PAIN
believe people because those pretending are so few and far between, not worth trying to pick them out

Question 4

Why do we experience pain? (as normal)

Answer 4

For protection…
Brain has many sources of information to make these pain decisions

Question 5

What can contribute to pain decisions in the brain?

Answer 5

body/nervous system
attention
expectation
past experience (inc trauma)
thoughts/words e.g. giving a diagnosis
senses
emotional state
feedback/response- how you react
etc…

Question 6

Why do SOME PEOPLE experience less pain?

Answer 6

lecture recording 12.16 - feedback/response

Question 7

How can pain be understood in DIMs and SIMs?

Answer 7

danger in me - dims
safety in me - sims
Theory that brain responds with pain when DIMs are more prevalent than SIMs
Can be mental as well as physical

Question 8

Sensitisation and reinforcement

Answer 8

Longer term pain, neurons that fire together find it easier to fire together again
commonly used pathways are more easily activated
‘smudging’ - less able to differentiate between specific source of pain

Question 9

How does the situation of sustaining an injury affect pain?

Answer 9

The situation happening at the time
How people around them react
e.g. athlete vs computer programmer breaking their leg
e.g. those who have been abused, body in a psychological state of threat

Question 10

Characteristics/ definitions of acute pain?

Answer 10

Warning
Explanation can be found
Can be cured
Time limited
Sympathy/believed
Goes back to ‘normal’

Question 11

Characteristics/definitions of chronic pain?

Answer 11

Nuisance - no useful warning purpose
Explanation not always possible
Managed, not cured
Ongoing
Less validation/belief
Life affected there onwards

Question 12

What are 2 common responses to pain?

Answer 12

‘take it easy trap’/avoidance
activity cycling ‘boom and bust’

Question 13

What is the ‘take it easy trap’?

Answer 13

Had acute pain, get told to rest initially, ‘take it easy’
Pain never leaves
Stay in that cycle
Avoid activities associated with pain
Reduce activity - lead to negative problems
Get conditioned to respond to the pain as if it were acute, even when the pain is no longer serving a purpose

Question 14

What are problems with the ‘take it easy trap’?

Answer 14

Less and less done over time
Loss of social contact
Loss of fitness and deconditioning
Depression
Reinforcing messages from the switchboard

Question 15

How to help with the ‘take it easy trap’?

Answer 15

Staying active (within ability)
‘Motion is lotion’
Pacing
not ab removing pain, ab managing it

Question 16

What is the boom and bust cycle? What are the problems?

Answer 16

Push through the pain, get the jobs done
Flare up, so forced to rest
Jobs build up so as soon as rested get them all done
Another flare up
Boom and bust

Damage-
Pain threshold becomes lower
Deconditioning the body, over time they experience more pain from doing less and quicker/more severe

Question 17

What are the 3 P’s that help with managing pain?

Answer 17

Pacing
Prioritising
Planning

Question 18

How can pacing help with pain?

Answer 18

Keep to a regular to a regular amount of activity, limiting time spent on an activity to prevent marked increases in pain
PLANNING not just going according to how you feel
Frequent short breaks, breaking larger tasks into smaller

Question 19

How can planning help to manage pain?

Answer 19

Think when and how activities are done
Spread out difficult activities
Balance essential and non-essential activities
Take regular breaks

Question 20

How can prioritisation help to manage pain?

Answer 20

Making difficult choices about what is done/what isn’t
Balance what needs to be done with what is pleasurable or interesting

Question 21

Challenges of the 3 P’s?

Answer 21

Sacrifice involved, a lot of difficult decisions in lifestyle?

Question 22

What methods other than the 3 P’s can be used in pain management?

Answer 22

Practicing relaxation - natural response to pain is muscle tension, make pain experience worse, relaxation has to be learnt
Distraction - block out/supress - can be difficult bc pink elephant is pain
Mindfulness - acceptance of experience
Changing the relationship with pain

Question 23

What is a ‘flare-up’?

Answer 23

Increase in a patient’s usual pain - NOT new pain sensations
Can occur quickly with no warning or gradually over time

Question 24

How can pain flare ups be managed?

Answer 24

Medication
3 P’s
Distraction
Support from others
Counter stimulation
Breathing control and relaxation
etc….