Flashcards on Pain Management

Flashcards reviewing key concepts from a lecture on the management of pain and discomfort.

Why is pain considered difficult to study?

Pain is subjective and heavily influenced by the context in which it is experienced.

What are the learning objectives related to pain management discussed?

Explain the role of social context, physiological aspects, neurochemical bases, techniques of pain measurement, comparison of acute and chronic pain, and techniques to control pain and their effectiveness.

What is the economic significance of pain in the United States, according to Gaskin & Richard (2011)?

Upwards of $635 billion annually.

What is the International Association for the Study of Pain's definition of pain?

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

What are the three kinds of pain perception related to nociception?

Mechanical nociception, Thermal nociception, and Polymodal (chemical) nociception.

What is the role of Substance P in pain physiology?

Involved in the transmission of pain impulses from peripheral receptors to the CNS.

What is the role of Glutamate in pain physiology?

Amplifies pain signal transmitted from spinal cord to brain and is implicated in chronic pain.

How is head and neck pain transmitted to the brain?

Directly transmitted via the 12 cranial nerves.

What is the function of A-delta nerve fibers?

Transmit sharp pain, especially mechanical or thermal pain.

What is the function of C-fibers?

Transmit dull, aching pain; Polymodal pain

Which brain areas are involved in pain control?

Periaqueductal gray and Cerebellum

What did the landmark study by D.V. Reynolds (1969) demonstrate?

Electrical stimulation of the brain can produce analgesia (Stimulation-Produced Analgesia, SPA).

What is the general role of endogenous opioid peptides?

Important in natural pain suppression. Must be triggered – stress response. Suppress immune functioning.

What is the main idea of Specificity Theory?

Specific pain fibers and pain pathways exist, making the experience of pain virtually equal to the amount of tissue damage or injury; Pain is a physical experience largely uninfluenced by psychological factors.

What is the main idea of Gate Control Theory (Melzack & Wall, 1965)?

Structures in the spinal cord act as a gate for the sensory input that the brain interprets as pain; A-beta, A-delta, and C fibers regulate the “gate”; Central control trigger consists of nerve impulses that descend from the brain and regulate the “gate”.

What is the main idea of the Neuromatrix Theory (Melzack, 1993)?

The neuromatrix is a network of brain neurons that processes sensory information but can act even in the absence of sensory input (e.g., phantom limb).

What are the key components of the Biopsychosocial Conceptual Model of pain?

Biological, psychological, and social factors all influence pain perception and experience.

How long does acute pain typically last?

Six months or less.

Give three examples of chronic pain

Chronic benign pain (e.g., chronic low back pain); Chronic recurrent pain (e.g., migraine headaches); Chronic progressive pain (e.g., cancer).

What is the 'pre-chronic pain' stage?

Time between acute and chronic pain. A crucial period where a patient either gets better or develops chronic pain.

What are some common pain behaviors?

Avoiding physical activity, social contacts, bright lights, loud noises, etc.

Name three ways pain is measured.

Rating scales; Visual analog scale (VAS); Questionnaires.

What factors are assessed by the Multidimensional Pain Inventory?

Pain characteristics, interference with lives and functioning, and mood.

Name some standardized tests used to measure pain.

Minnesota Multiphasic Personality Inventory (MMPI & MMPI-2); Beck Depression Inventory (BDI); Symptom Checklist 90-Revised (SCL-90-R).

What is Electromyography (EMG) and what does it measure?

Measures muscle tension. Little relationship with self-report pain.

What are some examples of automonic indices used in physiological pain measurement?

Hyperventilation, blood flow in the temporal artery, heart rate, hand surface temperature, surface temperature, finger pulse volume, skin resistance level .

Name 4 methods of pain control.

Pharmacological agents; Surgery and medical devices; Complementary and alternative medicine; Cognitive-behavioral techniques.

Describe Sensory Control and give some examples.

Counterirritation à Inhibiting pain in one part of the body by stimulating or mildly irritating another area; Dorsal Column Stimulation à Electrodes near the nerve fibers from the painful area deliver a mild electrical stimulus, thus inhibiting pain; Transcutaneous electrical nerve stimulation (TENS) à Electrodes attach to the skin and provide electrical stimulation

How can Biofeedback help with pain control?

An individual is provided with Ongoing specific information about a particular physiological process by a machine So that s/he can learn how to modify that process

How does distraction help relieve pain?

Attention is redirected to reduce pain and is effective for acute pain and low-level pain.

How does Cognitive Behavioral Therapy (CBT) help relieve pain?

Aims to develop beliefs, attitudes, thoughts, and skills to make positive changes in behavior

What is the key element of Pain Management Programs?

Programs that make available to patients all that is known about pain control to help manage chronic pain.