Understanding pain Flashcards
Pain definition
Pain is an unpleasant and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
What is pain? What are the features?
Pain is a construct – you can’t always tell when someone has it. It has sensory features – its quality and intensity. Affective – how unpleasant it is. Physiological – nociception (perception of the pain). Pain is often expressed through facial expression, vocalisation, complaint, rubbing/holding/guarding, posture change, taking pain relief
What is the lay view by Descartes on pain?
Lay view- Descartes explaining the stimulus model with fire at foot leads to pain which is understood the brain like pulling a rope connected to a bell.
What is the Gate Control Theory and who came up with it?
Non-painful input closes the “gates” to painful input, which prevents pain sensation from traveling to the central nervous system. Therefore, stimulation by non-noxious input is able to suppress pain. If gate open then CNS experiences more pain; closing them will decrease it.
What is a transcutaneous electrical stimulation (TENS)?
TENS (transcutaneous electrical stimulation) = a device for pain management. This is where you stimulate area of pain by giving electrical shocks- could be said to close gate
What is the bottom up process?
- sensory driven
- processes that organise incoming information
What is the top down process?
- driven by knowledge, experience, and expectations
- determine perception in ambiguous settings
What are the advances of the Gate Control Theory?
- pain as a perception
- individual as active
- individual variability expected
- multiple causes of pain
What are the problems with the Gate Control Theory?
- physical evidence of the gate?- central & peripheral neurotransmitters
- still assumes an organic basis for pain
What is phantom pain?
Phantom pain = experienced by 70% of amputees – a feeling of pain in the missing limb or organ. They have lost that part of the body but they still hurt because they think of that area hurting. Can increase due to mood. Rerunning the pain in the head- imprinting.
What is virtual walking?
Came up by Moseley
Watching healthy versions of themselves (e.g. paraplegics watch themselves walking). Decrease in pain and increase in duration of pain relief.
What are the thresholds, duration and quality of pain?
Pain has thresholds (sensation, perception, tolerance), duration (acute or chronic) and quality (superficial, deep or referred).
Who came up with the theory about the Himalayan climbers?
(Clarke & Clarke) - Nepalese climbers had a much higher pain threshold than Western climbers (tolerance and motivated tolerance)
What are stoical patients?
Require more compassionate care, a Westernised view
How can you cope with acute pain?
Relative anaesthesia (mild sedation e.g. N20, valium)- don’t want full anaesthetic but don’t want no pain
