Pain Theory Flashcards
What is pain transmitted via through the body
Nocioceptors
When was the pain gate theory established
When did pain become more of a holistic model
1965
1990
How do nocioceptors work
Nocioception
They are sensory nerves that respond to damaging stimuli by sending signals to spinal cord and brain
What are the different types of pain the body can feel
Thermal - harmful heat or cold
Mechanical - excess pressure or deformation
Chemical - wide variety of chemicals
How is the duration of a stimulus / how long pain lasts conveyed
By the firing pattern of receptors, after a harmful stimuli, the mechanoreceptors may continue firing action potentials
What does the pain gate control theory suggest happens during the body when experiencing pain
(1965 - melzack and wall)
Pain is not a straightforward transmission of sensory information from damaged tissue to brain
There are gates on the nerve fibres between peripheral nerves and the brain, these gates help control how pain messages flow from the PNS to the CNS - gate opens and closes in spinal cord based on the interaction between sensory and emotional factors
If something hyper-stimulates the A-beta fibres in the area experiencing pain, a reaction is caused from nearby inhibitory neurones which will mute the pain signals before they reach the spinal cord and brain ultimately putting a damper on pain
What are the 2 types of fibres that cause either a sharp pain or a dull ache
A-delta = myelinated fast nerve fibres = sharp pain
C nerve = non-myelinated slow nerve fibre = dull ache
What came about from melzacks pain gate theory and hyper-stimulisation of a-beta nerve fibres
The medic community looked for treatments that could help create hyper-stimulation to inhibit pain signals
They found that massage, acupuncture and electotherapy affect the A-beta nerve fibres
What are the 2 components of pain in patients
Individualised loudness of pain
Cognitive-behavioural affects which relates to BPS model
What is the nueromatrix model of pain (Melzack 1990)
How does this relate to our roles as GSR
It recognised 3 broad dimensions of pain
Cognitive evaluative - expectations, beliefs, coping
Sensory-discriminative - location, intensity, duration
Affective-motivational - thoughts, feelings of stress
Help patients manage the perceived threat of activities/exercise through the use of, for example, progressive exercise programmes and patient education on pain.
How is the BPS integrated into individualised perceptions of pain and exmanination of our clients
Describes how our biology relates to our psychology and social interactions which can affect our pain
In subjective examination, yellow flags should be established that are barriers to recovery
The model is an accepted part of management for low back pain.
Its important to ask patients questions related to their thoughts, expectations, understanding of condition and what impact it’s having on their life
Key points for using the BPS model in sport rehabilitation.
Always carry out a diagnostic triage first to exclude any serious pathology and red flags
Isolated behavioural signs don’t mean anything - multiple findings are significant
Presence of behavioural signs doesn’t mean the patients problem is just psychological, presence of pathology can significantly impact a persons behaviour
Illness behaviour isn’t a diagnosis, they alert the potential of poor recovery and are prognostic indicators
What is predictive processing by Jolly and Thacker 2012
Pain is an embodied element of suffering encapsulated by an experience of the person within the society and culture in which they live
Our consciousness is predictive rather than reactive, sensory info that comes in is used by the CNS to compare with its predictions which is then used to generate our reality
Synapses now has 3 types of cells that can signal across cells = multipartate
What is the differences between acute and chronic pain
Acute =
Sudden onset, nociocpetove, temporary, somatic/visceral/referred
Increase RR, HR, BP
MEDS ARE AFFECTIVE
chronic =
Persistent pain over 3 months
Nocioceotive and neuropathic
Unknown cause
Less obvious physiological responses
Limited effects of meds
What is neuropathic pain and what are the types of neuropathic pains in the body
A pain initiated or caused by a primary lesion or dysfunction in the nervous system
MSK = entrapment nueropathy
Trauma = stretch related injuries
Nuero = guillian-barre, multiple sclerosis
Other - diabetes, alcoholism
