Week 9 (B) - Complete Flashcards
(13 cards)
What portion of depression payments have chronic pain?
~60%
What proportion of chronic pain patients have depression?
50%
Pain relief from meditation occurs because meditation releases endorphins, T/F
FALSE
Meditation…
- REDUCES pain related activation of SOMATASENSORY CORTEX and INSULAR
- INCREASES activation of the ANTERIOR CINGULATE
- REDUCES activation of AMYGDALA and negative emotions in response to pain
How does reducing sleep (SWS & REM) encourage HYPERALGESIA?
Four possible mechanisms
- Less sleep = poorer descending pain inhibitory pathway
- Less sleep = more Inflammation
- Less sleep = poorer attention regulation (meaning more easily focus on pain)
- Less sleep = greater central sensitisation too pain
In Fibromyalgia, what are the TWO changes in the CENTRAL PROCESSING of pain?
- Lower pressure pain threshold
2. Increased somatasensory activation for any level of pressure
In Fibromyalgia, what is the ONE change in the ASCENDING PATHWAY of pain?
(Increased amounts of TWO substances in the CSF)
Increased CSF substance P and Nerve Growth Factor
In Fibromyalgia, what are the TWO changes in the DESCENDING PATHWAY of pain?
- Increased CSF serotonin and norepinephrine
2. Reduced rostral anterior cingulate activity
Patients with Fibromyalgia typically have insomnia, T/F
NOT QUITE,
Not insomnia, but restless sleep wth frequent waking
Can poor sleep predict Fibromyalgia development?
YES!
According to Norwegian study and also UK study
What happens if you help someone with Fibromyalgia sleep by giving them SODIUM OXYBATE (GHB)?
(In terms of their symptoms)
- Pain improves
- Sleep and fatigue improve
- Quality of life improves
What happens if you help someone with Fibromyalgia sleep by giving them CBTi?
(In terms of their symptoms)
- Sleep and fatigue improve
- Daily functioning improves
- Pain catastrophising improves
- PAIN DOES NOT IMPROVE!
What is the best way to prevent chronic pain?
Prevent acute pain
What are the FOUR ways sleep loss increases/influences pain?
- Reducing pain inhibition
- Increasing inflammatory cytokines
- Reducing inhibition from distraction
- Modified central in a sensitisation
