Pain Flashcards
Define Pain
an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage
Describe the biopsychosocial model of pain
Pain affects all aspects of one’s life
Reduced quality of life and general health
Mental and emotional health
Increased risk of suicide
Problems with cognitive function, such as reduced processing speed, selective attention, memory, and executive functioning
School/work absence and reduced productivity
Increased disability and inactivity
Decreased social connections and supports
Increased health care utilization
How can pain be classified?
Compare acute vs chronic pain?
Define nociceptive pain
Arises from damage to body tissue; typical pain one experiences as a result of injury, disease, or inflammation
Usually described as sharp, aching, or throbbing pain
e.g., burning your hand on a hot stovetop (tissue damage = adaptive)
Define neuropathic pain
Arises from direct damage to the nervous system itself, usually peripheral nerves but can also originate in central nervous system
Usually described as burning or shooting/radiating, the skin might be numb, tingling, or extremely sensitive – even to light touch (allodynia)
e.g., post-herpetic neuralgia (i.e. shingles pain)
Define nociplastic pain
Arises from a change in the way sensory neurons function, rather than from direct damage to the nervous system; sensory neurons become more responsive (sensitization)
Usually described similar in nature to neuropathic pain
e.g., fibromyalgia (no tissue damage = maladaptive)
Chronic pain is always associated with….
Nociplastic Pain
Types of nocicpetive pain
Noceceptive Pain Pathway
A-delat – myelinated – fast
C-fibre – slow, not as fast – not myelinated
Thalamus is the relay system
Modulation – Brain telling the body to react (you need to do something; you can relax)
Noci Transuction
Noci Conduction
Noci Transmission
A-δand C-nerve fibers synapse in various layers (laminae) of the spinal cord’s dorsal horn
Release excitatory neurotransmitters (e.g. glutamate, substance P)
N-type voltage-gated calcium channels regulate the release of these excitatory neurotransmitters
Pain signals reach brain through various ascending spinal cord pathways (including spinothalamic tract)
Thalamus acts as relay station within brain
Pathways ascend and pass impulses to higher cortical structures for further pain processing
Noci Perception
Pain becomes a conscious experience
Occurs in higher cortical structures
Physiology of perception is not well understood
Cognitive and behavioural functions can modify pain
Relaxation, distraction, meditation may ↓ pain
Depression, anxiety ↑ pain
Noci Modulation
Compare the types of neuropathic pain
Describe the process of nociplastic pain
