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Flashcards in Understanding Pain Deck (58)
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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?

14 million

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

2. sensory

3. affective

4. cognitive

5. behavioural


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"

3. complaints

4. rubbing/holding/guarding

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


What are the descriptors in the McGill pain questionnaire?

1. sensory
2. affective
3. evaluative
4. temporal (how much pain varies)