Pain Flashcards
Who is Henry K. Beecher?
He compared soldiers pain in WWII to male civilian patients. Went to harvard and is known for his work in placebo effect and research ethics.
Said patients at home said they were in more pain (wanted meds) more than the soldiers.
There is no correlation betwenen physical injury and how much pain you feel. Pain is relative and subjective
What is the definition of pain?
Ken Craig
Pain is a distressing exprience associated with actual or potential tissue damage with sensory (sharp/dull), emotional (feeling anxious or upset), cognitive (judgements and expectations) and social (communicating/acting like ur in pain) components.
Potential: guy who had a nail in his foot.
What is acute vs chronic pain? Types of chronic?
Acute < 6months, chronic is > 6 months.
- Chronic benign: always present but unrelated to a medical condition
- . Reccurent acute: intense periods of pain followed by periods of relief.
- Chronic progressive: continuous discomfort that becomes worse as condition progresses.
What are the functions of pain?
Intrapersonal: signals what you need to do, motivate us to escape, warn us about tissue damage
Interpersonal: signals that you need help.
- problems, stigma with pain and makes you vulnerable.
What is the traditional biomedical perspective on pain?
Greater injury leads to greater pain, focus on sensory mechanisms, medical focus on pharmacological and surgical interventions.
THis doesn’t add up cause two ppl with the same injury will differ in their pain response. Sometimes pharma and surgical interventions don’t work! There are dangers to using opiods for pain management.
What are the psychological factors involved in pain?
Anxiety, depression,
catastrophizing,
sense of control, avoidant behaviors (cutting back on exercising)
Impact on social relationships
What is Nociception?
Pain perception. You have nociceptors all around your body that detect actual or potential injury and communicates this info to spinal chord and brain.
- mechanical injury
- chemical injury/polymodal
- thermal injury
Sends info through spinal chord to the brain.
What are the nerve fibers involved in nociception?
A delta: small, transmit initial sharp pain fast (myelinated)
C fibre: small, slower, transmit dull longer lasting pain
A beta: large, fast (myelinated) responds to touch, supresses C fibres. Massage or heating pad
What is the Gate Control Theory of Pain?
Melzack and Wall
Neural gate that opens or closes pain signals to the brain.
CLose gate will reduce pain (A beta fibers) - distraction , positive emotions, relaxation, counterstimulation, massage
Opening gait will increase pain (a delta, c fibres) - depression, anxiety, boredom, overattention.
Central control: brain sends signals to modulate pain, explains cognitive and emotional factors and their influence on pain.
Info goes to the brain depending on how open/closed the gate is.
Signals sent back down from brain determine pain felt.
What is the neuromatrix theory?
Why people feel pain even when there are no sensory inputs? (phantom limb pain)
- neuromatrix is a network that generates bodily perceptions and pain
- each pain experience creates a unique pattern of nerve impulses called “neurosignature”
Neurosignatures can cause pain even without sensory input.
SO if you lose a limb due to this neural matrix you may still have feelings that are not there.
Neuromatrix is genetically determined but is also modified through life.
Who is Dr. Ronald Melzack?
Rethought how pts. feel pain. COmplicated pain. Biggest research on phantom limbs.
Used gate control theory to develop neuromatrix theory. Wanted to solve puzzle of pain.
Created first pain clinic.
What is the mcgill pain questionnaire?
Sensory qualities, affective qualities and evaluative terms. Used a lot in medicine and uses a lot of words to describe pain.
Nonverbal expressions of pain?
Facial expressions,
Vocalizations
Body language
What are Pain treaments?
Pharmacological (opiods, painkillers, cannabis, antidepressants)
Sensory approaches (counterirritation, electrical nerve stimulation, exercise and staying active)
Cognitive treatments
- relaxation
-meditation
-guided imagery
-distraction
-cognitive restructuring “this pain is manageable, i’m coping well”
