Flashcards in Pain Deck (30):
What is Pain?
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
What is pain a warning of?
A warning of actual or potential tissue damage; it is a combination of mechanical, neurological, psychological and sociological factors; response of nociceptors to noxious stimuli
What is pain a response of?
Nociceptors to noxious stimuli; peripheral sensitization due to release of local chemicals; central sensitization
What is pain 100% from?
The brain; it is a multiple system output, activated by an individual's specific pain neural signature. The neural signature is activated whenever the brain perceives a threat.
How can you assess pain?
Visual analog and numeric scales; comparison with predefined stimulus; semantic differential scales; daily activity/ pain logs; body diagrams; open ended, structured interviews; physical examination and testing * Make sure to take cultural differences into consideration
What is the Primary Afferent Neuron A-delta?
Responds to intense mechanical stimulation and heat or cold; short duration, sharp, stabbing, or pricking sensation; small and myelinated
4-30 m/s, 20% of pain afferents; not blocked by opiods
What is the Primary Afferent Neuron C-Afferent?
Longer duration, dull, throbbing, aching, burning, tingling, diffusely localized, accompanied by sweating, increased heart rate and blood pressure, and nausea; small and unmyelinated; 0.5-2 m/s, 80% of pain afferents can be blocked by opioid medication
What is the Primary Afferent Neuron A-Beta?
non-painful sensation related to vibration, stretching, and mechanical pressure
What is Superficial/ Skin pain?
Sharp/pricking/vibrating and easily located
What is Musculoskeletal pain?
Dull/ Achy and more difficult to localize
What is Visceral pain?
Aching quality, frequently referred superficially.
What are the two pain control systems?
Endogenous Opioid system and Gate Control
What is Pain control by the Endogenous Opioid System?
Different Chemical (Opiopeptins- aka endorphins, Enkephalins, and Dynorphins) control pain by binding to specific opioid receptors in our body- in times of emotional stress these are released into the body which raises the pain threshold. When the pain threshold is increased we don't respond to that stimuli with as much pain as we did before. Example: if you hurt yourself and then hurt yourself in another area that first area won't hurt as much anymore. Also, possible explanation for noxious stimuli.
What is Pain control by the Gate Control Theory?
We have A-delta and C fibers that open the gate and therefore results in pain within our nervous system. If we can stimulate afferent fibers (non-painful fibers) those can actually close the gate and have the result of decreasing the sensation of pain. The Tens unit works with this, also if you hurt yourself and then you start rubbing that area- it utilizes the gate control pain theory to help decrease that pain.
What is Transient Pain?
Elicited by activation of nociceptive tissues in the body in the absence of tissue damage; goes away without treatment
What is Acute pain?
Usually relatively short duration; defined etiology; may be localized; reflex mechanism for protection from damage
What is Chronic/ Persistent pain?
Longer duration, often persisting longer than typical for a condition; often inadequate response to appropriate care; associated with more emotional reactions
What is Nociceptive pain?
Has a clear stimulus-response relationship with the initial injury
What is Neuropathic pain?
Burning or lacinating quality; usually accompanied by signs or symptoms of neurological dysfunction, such as paresthesias, itching, anesthesia, weakness
What is referred pain?
Pain may be acute or chronic; in many cases pain is away from the origin/ sources of pain
What is Radicular Pain?
Travels along a nerve; may be due to compression, inflammation and/or injury to a spinal nerve root arising from common conditions including herniated disc, foraminal stenosis, and peridural fibrosis
What is Peripheral Sensitization?
increased sensitivity to an afferent nerve stimuli
What is central sensitization?
Condition of the nervous system that is associated with the development and maintenance of chronic pain
What is Primary Hyperalgesia?
Increased duration and magnitude of CNS response
What is Secondary Hyperalgesia?
Enlarged receptor field; pain starts to spread
What is Allodynia?
Non- noxious stimuli becoming painful; when a patient experiences pain with things that are not normally painful; touch or massage
What are the goals of care when dealing with Pain management?
Resolving underlying pathology when possible; modifying discomfort and suffering; maximizing function within the limitations imposed by patent's condition
How can we managed persistent pain?
May need integrated multidisciplinary treatment; psychological and physiological therapies, physical agents, and exercise
What are the most commonly used physical agents?
Cryotherapy; thermotherapy; Ultrasound; Electrical Stimulation; Traction