Psychological aspects of pain Flashcards

1
Q

Pain =

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage and expressed in terms of such damage

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2
Q

What role might acute pain have?

A

Protective

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3
Q

Self-limiting pain =

A

Acute

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4
Q

2 broad types of pain:

A

Nocicpetive

Neuropathic

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5
Q

Nociceptive pain is associated with =

A

Actual tissue damage

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6
Q

2 types of nocicpetive pain =

A

Visceral

Somatic

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7
Q

Somatic pain =

A

Easily localised and describes

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8
Q

Ex of somatic pain =

A

Fracture

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9
Q

Visceral pain =

A

Poorly localised and describes. Associated with activation of nociceptive of organs

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10
Q

How might visceral pain be described?

A

Aching, dull, burning

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11
Q

Neuropathic pain is associated with

A

Structural neural damage or abnomral processing

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12
Q

How might neuropathic pain be described?

A

sharp, stabbing, burning, shooting,

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13
Q

Which kind of pain doesn’t respond well to conventional analgesics?

A

Neuropathic

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14
Q

Time line: acute pain

A

< 3 months

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15
Q

Time line: chronic pain

A

> 3 months

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16
Q

Chronic pain:

A

> 3 months

unpredicatable, unknown circuitry, difficult to treat, not useful

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17
Q

Mechanisms by which a chronic pain state is established =

A

Peripheral senstisation
Central sensitiasaion
Central reorganisation

18
Q

Peripheral sensitisation =

A

Tissue damage leads to release of neuropeptides and inflammatory mediators. This reduces the threshold for activation of peripheral receptors

19
Q

Central sensitisation =

A

Increased primary afferent release of glutamate and substance P activated NDMA receptors. Winds up CNS so it is hyperactive

20
Q

Nociceptive neurotransmitters

A

Glutamate

Substance P

21
Q

Pain receptor =

A

NDMA

22
Q

Hyperalgesia =

A

exaggerate pain response

23
Q

Allodynia =

A

Pain response to non-painful stimuli

24
Q

Central reorganisation =

A

Changes to dorsal spinal cord and cortical sensory matrix

25
Q

Co-morbidities associated with pain =

A
Poor appetite
Anxiety
Depression
Difficulty concentrating
Lack of energy
Difficulty sleeping
26
Q

Aspects of psychological parts of pain:

A
Cognitive
Behavioural 
affective 
Coping strategies
Emotions
Beliefs
Illness behaviour
27
Q

Affective response to pain =

A

pain causes anxiety and depression which worsens pain

28
Q

Behavioural response to pain may include:

A

Fear-avoidance

29
Q

Fear-avoidance =

A

avoidant behaviour based on pain-related fear helps to maintain chronic pain state

30
Q

Cognitive response to pain may include

A

Somatisiation

Catastrophising

31
Q

Positive social aspects

A

Sympathy
Support
Attention

32
Q

Negative social aspects

A

Income
Hobbies
Loss of role in family

33
Q

Common issues in chronic pain:

A
  • Not often associated with real tissue damage
  • Not associated with positve investigations
  • Psychosocial
  • Impairment and disability
  • difficult to manage
  • relaistic outcomes
34
Q

Impairment =

A

Any loss or abnomrality of psychological, physciological or anatomical structure or function

35
Q

Disability -

A

restriction or lack of ability to perform activity in a manner considered normal

36
Q

Pain red flags =

A
Hx of cancer
recent bacterial infection
immunosuppression
constitutional symptoms
Radicular symptoms (radiates)
37
Q

Pain yellow flags =

A

Fear that pain is harmful
Fear avoidance behaviour
Social withdrawl/low mood
Passive rather than active treatment

38
Q

Chronic pain treatment strategies =

A
Physcial
Self-help
Non-pharma
Psych
Pharma
39
Q

Psychosocial interventions:

A
Education
Coping
CBT
Mindfulness
Pain management program
40
Q

Education about chronic pain may come in the form of

A

Expert patients program

41
Q

CBT aims to

A

challenge cognition and negative thoughts. develop strategies (e.g. thought diversion, relaxation, pacing)

42
Q

Physcial therapies include:

A
Hydrotherapy
Manipulation
Acupuncture
TENS
Exercise/fitness