Lecture 5.1 - Pain Flashcards
What is the IASP definition of pain?
An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage
What timeframe separates acute and chronic pain?
Acute - less than 3 months
Chronic - Over 3 months
What is the etiology of acute pain?
Related to underlying tissue damage - is protective
–> Pain proportionate to tissue damage
What is the etiology of chronic pain?
Related to central sensitization (non-productive)
–> May be out of proportion to physical findings
How does anxiety, worry, and depression affect pain perception?
Opening the gate and increasing pain
How does distraction, relaxation, and positive emotion affect pain perceptions?
Close gate and decrease pain perception
What is central sensitization?
A pathological process where the CNS changes in a way that alters processing of pain/other stimuli
–> Heightened pain response
What is the goal of assessment of acute pain?
Confirm the etiology
What is the goal of assessment with chronic pain?
Rule out secondary sources of pain
What are different causes of cancer pain?
Disease process, treatment, or diagnostic tests
–> Peripheral neuropathy seen with chemotherapy
What kinds of pain are associated with surgical pain?
Inflammation, neuropathic, myofascial, phantom limb, dressing changes
What is allodynia?
When a non-painful stimulus induces pain signal
–> e.g., light touch producing pain
What is myofascial pain?
Stemming from the myofascial system
–> Described as stiff, tight, tense, sharp, radiating
What is hyperalgesia?
When a painful stimulus causes severe pain out of the proportion to the stimulus
–> BP cuff/venipuncture causes severe pain
What are the element of the biopsychosocial model of pain?
Biological, social, physical
What are relevant Hx questions related to pain to ask a patient?
Surgical history
History of similar pain
Complex pain diagnosis - diabetes, neuropathic pain
What are some red flags with pain assessment?
Pain associated with fever
Weight loss
Waking during the night
Associated with neuro deficits/radiculopathy
When is a self-report pain rating scale appropriate?
For children 3-4+ years of age
When would a behavioural pain assessment tool be useful?
For infants or children under 4, or for children and teens who are over 4 and nonverbal
With what age group is the Wong-Baker scale appropriate?
Children older than 3
With what population can the numeric rating scale be used to assess pain?
Children 5+ who are able to count
Most often used in children 8+
What are some limitations of self-report pain rating scales?
Assesses quantity, but non quality or features
What are the challenges of behavioural pain measures?
It can be hard to discriminate pain from anxiety or another distressing factor.
Must consider developmental age of child, as well as parental input of their child’s pain behaviour
What population is the NIPS used for? How long should the pt be assessed for?
up to 1 year of age
–> Monitor for minimum of 30-60 seconds
