Pain lecture Flashcards
(40 cards)
Define acute pain
- well-defined source
- autonomic and reflex signs
- emotional distress abates when cause is eliminated
What is nociceptive pain?
- injury to muscles,bones,ligaments, skin
- can be nociceptive somatic OR
- nociceptive visceral (gut, uterus, stomach)
Define pain
subjective experience -
associated with tissue damage or described in such
Prevalence of chronic non cancer pain (CNCP)
10-17% prevalence
maybe up to 29%
- prevalence varies according to population
Define disease
- Disease - clinical entity associated with disturbed function or structure of body part
Define illness
1- symptom perception
2 - symptom interpretation
3 - symptom expression
4 - coping behaviors
How does the medical model of disease view illness?
- Physical pathology
- Proportional to symptoms and disability
- psychological elements are secondary
What determines the nature/extent of a painful experience?
- attention
- appraisal
- coping strategies
- social experiences
- cultural variations
What are pain behaviours?
- verbal (verbalization,moaning)
2. non-verbal (grimacing, limping, gesturing)
When does the vulnerability to chronic pain increase?
- Physical or sexual abuse
- Marital discord
- Family violence
- psychoemotional trauma
- family members with pain/disability
- exposure to psychosocial or personal stressors
Define chronic pain
- lasts >6 months
- beyond regular healing time
- autonomic and reflex changes diminish with time
- psychological responses augment
When is chronic pain a biomedical condition?
- persistent/recurrent pain of nociceptive/neuropathic origin
- Life goes on despite limitations
when is chronic pain a disorder or syndrome?
- persistent/recurrent ALL the time
- underlying pathology has healed
- sadness,hopelessness, social isolation….
What are some red flags for the development of chronic pain disorders?
- Intense prolonged pain
- spreading pains or new pains
- failure to respond to treatment
- PTSD, anxiety, seriously depressed after injury
- Mistaken/pessimistic beliefs
- workplace difficulties
- employer can’t provide modified work
What is neuropathic pain?
- primary injury or dysfunction of CNS or PNS
2. injures peripheral nerves, spinal cord, brain
How do we explain extraordinary trauma in cultures?
- Internal pain blockers (endorphins)
- Altered states of mind (hypnosis)
BOTH
What are alpha waves?
- Fast waves, occur at 8-13 cycles/sec
2. during regular, conscious activities
What are theta waves?
- slower waves, 4-7 cycles/sec
2. seen during light sleep, creative thought, detach from reality
which types of waves are seen in hook-hanging etc?
Theta waves
How does hypnosis suppress pain?
- Splitting consciousness
- activating spinal cord descending pathways (block pain signals)
- alters the meaning of pain - targets unpleasantness
How does hypnosis NOT work to suppress pain
By mobilizing the endogenous opioid system
what is a placebo?
- ineffective treatment believed to be effective
2. change in illness due to symbolic effect not pharm effect
What can placebo responses do?
- relieve pain
- Angina
- bronchospasm
- twisted posture or tremors or increase range of movement
what % of treatments have a placebo effect?
70%!
