Chapter 12 - Managing and controlling clinical pain

what is clinical pain

any pain that receives or requires professional care

what is acute clinical pain

short-term pain that is often from injury or surgery; typically resolves as healing occurs

what is chronic clinical pain

long-term pain that may persist beyond injury or without clear cause; difficult to treat and emotionally taxing

what are the surgical methods for treating pain

neuroablation

synovectomy

spinal fusion

what is neuroablation

surgery removes or disconnects part of the PNS or the spinal cord, preventing pain signals from reaching the brain

what is synovectomy

removal of membranes that become inflamed in arthritic joints

what is spinal fusion

a procedure that joins two or more adjacent vertebrae to treat severe back pain

what are the 4 types of chemicals that are commonly used in treating pain

peripherally active analgesics

centrally active analgesics

local anaesthetics

indirectly acting drugs

what are the advantages of group psychotherapy over individual therapy in treating pain

efficiency

reduced isolation

credible feedback for patients

a new reference group for patients

a different perspective for the therapist

what is the operant approach

treatment focuses on reducing reinforcement for pain behaviour and increasing activity

• Identify pain behaviors: e.g., verbal complaints, visible discomfort, avoidance of activity.

  Reduce reinforcement for maladaptive behaviors: e.g., family members may be guided not to respond with excessive sympathy to pain complaints.

  Increase reinforcement for healthy behaviors: e.g., rewarding or encouraging activity, movement, or participation in daily tasks.

  Use shaping and reinforcement schedules: Gradually reward small steps toward normal activity levels.

do relaxation and biofeedback help relieve pain?

yes

what are some of the common techniques to reduce pain through cognitive methods

distraction

nonpain imagery

pain redefinition

what is a con for distraction

individuals vary in the pain relief received from distraction

what is nonpain imagery

person tries to alleivate discomfort by conjuring up a mental scene that is unrelated to or incompatible with the pain

what are pros for nonpain imagery

do not have to rely on the environment to provide a suitably distracting stimulus

what is a limitation for nonpain imagery

some individuals are less adept in imagining scenes than others

what is pain redefinition

one substitutes constructive or realistic thoughts about the pain experience for ones that arouse feelings of threat or harm

what is the significance of pain acceptance?

better pain acceptance → better functioning

what is acceptance and commitment therapy (ACT)

a cognitive-behavioural approach that teach clients to experience their condition and emotions directly, without the negative implications that have usually accompanied them

which cognitive strategies are better for acute pain?

distraction and imagery

which cognitive strategies are better for strong pain

redefinition

which cognitive strategies are better for chronic pain

redefinition

what is the most effective way to treat pain

a combination of methods

can hypnosis eliminate acute pain?

people vary in their ability to be hypnotized so different results

what is interpersonal therapy

IPT addresses the way pain impacts a person’s social relationships, and how relationship stress can, in turn, affect the experience of pain.

Pain is not just a physical sensation — it’s influenced by social context and interpersonal stress.

what are the limitations of the operant approach to pain relief

some revert to old patterns when operant intervention ends and rewards are discontinued

not all chronic pain patients are likely to benefit from operant methods: worse for chronic progressive

what are the pros of the operant approach to pain relief

best for patietns with chronic-recurrent or chroinc-interactable-benign pain

For which type of chronic pain is the operant approach least likely to be

successful?

A. recurrent

B. intractable

C. progressive

D. recurrent-progressive

E. It is not successful with any type of chronic pain.

C. progressive