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1 - APM (Anxiety & Pain) > The Puzzle of Pain > Flashcards

The Puzzle of Pain Flashcards

1
Q

What’s the biopsychosocial approach to understanding pain

A
  • Cognitive, motivational, judgemental and psychologic processes influence the transmission of nociceptive impulses at the first synapse and all subsequent levels
  • Influential factors include learning, personality, past experience, culture, and conditioning
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2
Q

Describe the ‘subjectivity of pain can be due to environmental load’ approach to understanding pain

A
  • An aversive, personal, subjective experience which disrupts ongoing behaviour and motivates the individual to attempt and stop the pain
  • Influential factors include cultural learning, the meaning of the situation, attention, and other psychological variables.
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3
Q

What’s the definition of pain

A

‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’

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4
Q

What are factors affecting pain experience

A
  • Context (placebos)
  • Cognitive set
  • Injury
  • Nociceptive
  • Chemical and structure neurodegeneration
  • Mood
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5
Q

What can pain trigger?
What are its psychological consequences?

A
  • Triggers help seeking behaviour
  • Has psychological consequences and can generate fear and anxiety
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6
Q

Components of the pain experience

A
  • Sensory
  • Neurophysiological and biochemical
  • Motivational
  • Behavioural
  • Lifestyle impact
  • Information processing
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7
Q

What is acute pain

A
  • ‘Adaptive and meaningful’
  • Pain from cuts, burn, surgery etc.
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8
Q

What is chronic pain

A

When three months for normal healing has lapsed but the pain has not subsided

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9
Q

Whats the gate control theory of pain (Melzack and Wall 1965)

A
  • A neural ‘gate’ in the spinal cord regulates pain experience
  • There are physiological and psychological causes to pain (not just sensory)
  • Pain is a perception and experience, not just a sensation
  • Patients don’t just respond passively to stimuli but actively interprets and assesses
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10
Q

What does information sent to the gate depend on

A
  • Behavioural state
  • Emotional state
  • The previous experience/self-efficacy in dealing with the pain
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11
Q

Explain what happens after large fibre stimulation

A

Large fibre stimulation → normal somatosensory input → gate closed

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12
Q

Explain what happens after a small fibre stimulation

A

Small; fibre stimulation → associated with pain (noxious information) → gate opened

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13
Q

What are endorphins

A

‘Happy hormones’ that stop pain affecting us

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14
Q

Whats the relationship between pain and anxiety

A

Bi-directional
Big booty beeeaaaches

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15
Q

What are informal techniques of controlling pain

A
  • Avoiding negatives
  • Reframing the sensation
  • Relaxation and lowered pain threshold
  • Distraction
  • Massaging the area
  • Apply pressure or stretching mucosa before injection.
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16
Q

Understanding pain: SOCRATES

A
  1. Site – where is the pain/maximal site of the pain?
  2. Onset – when did it start? sudden, gradual progressive, regressive?
  3. Character – what is it like? ache, stabbing, sharp, dull?
  4. Radiation – does the pain radiate anywhere?
  5. Associations – any other signs or symptoms with it?
  6. Time course – does the pain follow a pattern?
  7. Exacerbating/relieving factors – does anything change the pain?
  8. Severity – how bad is the pain (scale of 1 to 10)
17
Q

Chronic orofacial pain cluster into a single group

A
  • TMJ pain (facial arthromygalgia) – most common
  • Atypical facial pain (PIFP)
  • Burning mouth syndrome
  • Atypical odontalgia
18
Q

What are the 2 axes in the diagnostic criteria for temporomandibular disorders

A
  1. Physical signs and symptoms
  2. Psychosocial symptoms
19
Q

What model is best for dealing with chronic pain

A
  • The biophysical model
  • Should be a collaborative, problem centred approach that is empathetic
  • Should be in a clear and calm manner for the patient
20
Q

What’s the biomedical framework for understanding pain

A
  • Pain is an automatic response to an external factor
  • Tissue damage causes the sensation of pain - sensation has a single cause
  • Psychological factors have no influence
  • Pain can be organic (injury can be seen) or psychogenic (injury cannot be seen)

1 - APM (Anxiety & Pain) (2 decks)

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