test 3 pain

Question 1

what are challenges of pain disorders

Answer 1

• how would you describe this pain?
• underlying cause of pain?
• how intense is the pain?
• how do we alleviate pain?

Question 2

what two factors is pain perception a combo of

Answer 2

1) pain sensation

2) reaction to pain sensation

Question 3

what are the three stages of pain

Answer 3

acute, prechronic, and chronic

Question 4

what is acute pain

Answer 4

normally brief from a cut, burn, injury; adaptive in that it signals the person to avoid further injury

Question 5

what is prechronic pain

Answer 5

pain that occurs between acute and chronic pain

Question 6

what is chronic pain

Answer 6

endures over months; no adaptive reason or biological benefit to the pain

Question 7

what are the types of chronic pain

Answer 7

neuropathic, mixed, and nociceptive

Question 8

what is neuropathic pain

Answer 8

nerve damage usually described as burning pain or numbness

• can be caused by HIV or diabetes
• most common in feet but can affect a variety of body parts

Question 9

what is diabetic neuropathy

Answer 9

type of neuropathic pain
60-70% of people with diabetes have some form of neuropathy
-most common in those with diabetes for 25+ years

Question 10

what is mixed pain

Answer 10

mix of nerve and joint and tissue pain

Question 11

explain migraine and chronic daily headache

Answer 11

type of mixed pain

• 12% in last year had migraines, 31% miss obligations and 25% went to hospital
• women more likely to experience than men, and has a curvilinear relationship with age (peak is early adulthood)
• more migraine pain at young age, opposite of chronic pain trends
• modifiable migraine triggers are alcohol, exercises, lack of sleep, stress, smoking
• non-modifiable migraine triggers are menstruation and upper respiratory infections

Question 12

explain fibromyalgia

Answer 12

type of mixed pain

• 2% have it, still a mystery but 80-90% of diagnoses are women
• links to accidents, infection emotional stress, trauma and auto-immune disorders

Question 13

what is nociceptive pain

Answer 13

body tissue or joint damage

-usually described as sharp

Question 14

what is arthritis

Answer 14

a type of nociceptive pain
-physiologically based disease that causes erosion of bones near joints or inflammation of tissue surrounding bones and joints

Question 15

what are the two types of arthritis

Answer 15

inflammatory and osteoarthritis

Question 16

what is inflammatory arthritis and types

Answer 16

chronic inflammation

rheumatoid arthritis: thought to be auto-immune, involves chronic inflammation of the joints

• more prevalent autoimmune disease
• progressive, becomes more severe overtime and leads to functional limitations
• usually affects multiple joints at same time while OA is isolated to one or two regions

gout: crystal induced arthritis, crystals are deposited in the joints
- more common than RA

Question 17

what is osteoarthritis

Answer 17

degeneration of body

• much more prevalent than other kinds of arthritis, most common in knee or hip
• cartilage has worn away which causes bone spurs to develop

Question 18

what is the prevalence of arthritis

Answer 18

increases with age and more common in women at all ages

-also higher in whites and blacks than hispanics

Question 19

what are the risk factors for arthritis

Answer 19

• while other forms of arthritis are more likely to be idiopathic, genetic or injury related, one proximal cause of gout is diet which can be modified
• those who are obese have a greater risk for the most common forms of arthritis

Question 20

what are common commorbidities of arthritis

Answer 20

• heart disease
• chronic respiratory conditions
• diabetes
• stroke

Question 21

what is the Universal Pain Assessment Tool

Answer 21

• self report measure of perceived pain
• rank 1-10 (10 being the worst) smiley faces represent pain levels
• can also use to assess specific system

-pain is subjective so self reports are not always ideal

Question 22

what are other options of measuring pain

Answer 22

1) observational: can observe how the person is behaving (facial expressions) to try and determine pain severity
- good for those who cannot self report

2) electromyography (EMG): measures level of muscle tension as pain may increase tension

3) heart rate: predicts perception of pain, but only for men
- we are making inferences that the physiological data is an accurate indicator of pain

Question 23

what is the best method of pain assessment to date

Answer 23

self report chart

Question 24

what are sex differences in pain perceptions

Answer 24

• women report higher pain in all conditions
• could be because they feel more pain (biological)
• or more comfortable reporting pain (psychological-men should act tough stigma)

Question 25

what are the race differences in pain perceptions

Answer 25

- black and hispanic americans report higher sensitivity to pain than white americans - hispanic americans twice as likely to receive no pain meds for bone fracture and blacks 66% likely than whites to receive medication

Question 26

what determines how pain is treated

Answer 26

how pain is signified by the patient and understood by the provider

Question 27

what is a study about race and pain perceptions

Answer 27

participant pain ratings were significantly lower for black than white targets - tests show that these results are not due to implicit or explicit racial bias - authors indicate that people reporting think black people are inherently tougher because they've faced more hardships (seems positive at first but it can cause racial bias and disastrous outcomes like an underestimation of pain)

Question 28

what are the two types of pain treatment

Answer 28

pain management vs. pain elimination

Question 29

what is pain management

Answer 29

- most causes of chronic pain involve this - depends on type of disorder and severity of pain - could involve therapy and/or medications - treating the symptoms not the pain itself because the pain cannot be eliminated

Question 30

what are surgical approaches for pain

Answer 30

- hip/joint replacement (normally for arthritis) - not always possible for every condition - damage due to neuropathy could result in limb removal

Question 31

what is neuropathy pain treatment

Answer 31

- using prescription meds that are primarily used to treat other disorders (antidepressants, anticonvulsants, opioids) - dont have to be depressed to benefit from these drugs (they can also help with pain)

Question 32

what are external options for pain treatment

Answer 32

- based on application of heat (infared heat technology and paraffin wax treatment) - icy hot patches, sprays and creams

Question 33

what are therapy and exercise options for pain treatment

Answer 33

- PT - problems 1) have to get patients to look past the short term pain to see the long term benefits 2) need to customize physical activity for each patient to keep motivation high **these types of treatments can be very effective for long-term reduction of pain**

Question 34

what is comorbidity with chronic pain

Answer 34

-anxiety has a high comorbidity rate with chronic pain (arthritis, migraine, back pain, etc) (about half of patients with pain report this comorbidity)

Question 35

what are psychological interventions to pain treatment

Answer 35

relaxation, behavioral, cognitive and cognitive-behavioral therapy

Question 36

what are complementary approaches to pain

Answer 36

- people with pain related disorders commonly report use of CAMs - acupuncture, massage, yoga, etc - often used with back pain

Question 37

what are coping and social support strategies to deal with pain

Answer 37

use of engagement - style of coping is important (problem focused and emotional focused) - more social support related to less depression, especially for women

Question 38

what is emotional disclosure

Answer 38

based on the idea that unresolved issues create stressors that have negative health consequences, shown to improve immune functioning and pain