Flashcards in Understanding Pain Deck (58)
What is chronic pain?
experiencing pain for 3 months of the year or more
How many adults experience pain?
What % of these are adult women and men?
37% adult women and 31% adult men
In which groups is chronic pain more prevalent?
Older people and low income households
How many times more likely are those experiencing pain going to visit the GP?
5 times more likely to visit the GP
What consequences can severe pain lead to?
What percentage of those with severe pain develop these consequences?
clinical anxiety and depression
69% of those with the most severe pain have these features
What % of adults reported pain in the last 12 months?
What % report more than 1 site of pain?
87% of adults reported 1 pain in the last 12 months
75% reported more than 1 site of pain
What is the consequence of having more pain sites?
More disability and distress
It is not simple cause and effect
How does the number of pain sites change with age?
What is this linked to?
it changes little after 20 years
There are links with maternal pain
Why is pain not an extraordinary experience?
It is a common day-to-day experience and a fundamental characteristic of living
What is congenital analgesia?
When someone cannot experience pain and register that their body is damaged
What does congenital analgesia lead to in childhood?
Increased amount of injury and physical health problems
Bones do not heal properly after being broken as children start becoming active far too early after injury
What is the IASP definition of pain?
An unpleasant and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
What is meant by "potential tissue damage" is identifying the source of pain?
The root cause of pain may not be able to be found
There may be no detectable reason in a physical examination to describe why someone may be in pain
What is the alternative definition of pain?
Pain is what the patient says it is and exists when s/he says it does
How is detection of the intensity of pain linked to the alternative definition?
You cannot detect the intensity of pain and must go off the patient's definition of where/how intense the pain is
Why is pain difficult to diagnose?
People build up their own internal representations of pain so it is a subjective experience
What are the 5 constructs used to assess pain?
1. physiological - nocioception
What is meant by nocioception as a construct?
The physiological responses to threat
It can be measured but it is quite invasive
What is meant by sensory as a construct?
The quality and the intensity of the pain
What is meant by affective as a construct?
This is the unpleasantness of the pain and how it affects someone's mood
What is meant by cognitive as a construct?
Expectations of pain and models of pain that are built up on previous experiences of pain
What is meant by behaviour as a construct?
How the individual vocalises their pain, how it affects their posture
What are typical pain behaviours?
1. facial expressions
2. para-vocalisation - "ouch"
5. posture changes
6. reduced behavioural repertoire
7. taking pain relief
How is pain assessed using the pain thermometer?
The patient rates how bad their pain is on a scale of 1 to 10
This is repeated on a number of different occasions to see what factors changed their experience of pain
What is significant about the appearance of the pain thermometer?
It is a fixed point rating scale with vertical orientation
What are visual analogue scales in pain rating?
They are 100 mm long and a line that reaches from "no pain" to "extremely painful"
How are visual analogue scales used to rate pain?
The patient marks the severity of their pain on the scale
The distance from the start is measured to give a numerical value for the severity of the pain
Why are visual analogue scales preferred to the pain thermometer?
Scale of 0-100 rather than 0-10
this gives more reliability and reflects differences in people's subjective experience to pain as it gives more precision in the way they communicate their experience
How does the McGill pain questionnaire work?
The patient picks out words that describes their current experience of pain
They colour in the body area affected
The pain rating index comes from summation of their pain descriptors