Foundations of Pain

This set of flashcards covers the key concepts, definitions, and implications of pain assessment and management as presented in the lecture notes.

Biopsychosocial Stressor

A complex factor that includes biological, psychological, and social aspects, contributing to the pain experience.

Definition of Pain

An unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Sensory Pain

Pain perceived through nerve activation and tissue injury signals from the body.

Emotional Pain

The aspect of pain that includes fear, anxiety, distress, and memory.

Subjective Nature of Pain

Pain is a personal experience; it does not require visible tissue damage and can be reported differently by each individual.

McCaffery’s Principle

'Pain is whatever the experiencing person says it is…' indicating the subjective nature of pain.

Self-Report

The gold standard for pain assessment, reflecting the patient's own experience of pain.

Sympathetic Nervous System (SNS)

The system activated in response to unrelieved pain, contributing to fight or flight responses.

Hypothalamic–Pituitary–Adrenal (HPA) Axis

A central stress response system activated during unrelieved pain.

Endocrine Effects of Pain

Pain activates the hypothalamus, leading to a cascade of stress hormones like ACTH and cortisol.

Cortisol

A hormone released during stress that can raise blood glucose and suppress insulin.

Metabolic Effects of Pain

Pain causes release of stress hormones that mobilize energy, leading to consequences like hyperglycemia.

Cardiovascular Effects of Pain

Pain can increase heart rate and blood pressure, and cause increased myocardial oxygen demand.

Shallow Breathing

A respiratory effect of pain that can lead to atelectasis and infection.

Genitourinary Effects of Pain

Pain can cause decreased urine output and fluid overload due to increased ADH and aldosterone.

Gastrointestinal Effects of Pain

Pain suppresses parasympathetic activity, leading to decreased gastric and bowel motility.

Musculoskeletal Effects of Pain

Pain can cause muscle guarding, fatigue, and increased risk of DVT.

Cognitive Effects of Pain

Pain can lead to decreased attention, memory, and decision-making abilities.

Developmental Effects of Pain in Infants

Infants and children can experience altered pain processing and increased stress sensitivity.

Chronic Pain Syndromes

Includes conditions like phantom pain, postherpetic neuralgia, and postthoracotomy pain.

Acute Pain

Pain due to tissue damage that is short in duration and resolves with healing.

Chronic Pain

Persistent pain that alters nervous system processing and may originate from cancer or noncancer sources.

Breakthrough Pain (BTP)

Acute flares of pain that occur in patients already experiencing baseline chronic pain.

Nociceptive Pain

Normal pain processing arising from injury or damage to tissue.

Somatic Pain

A type of nociceptive pain arising from skin, muscles, bones, joints.

Visceral Pain

Nociceptive pain arising from visceral organs, often poorly localized.

Neuropathic Pain

Pain arising from nerve injury or dysfunction; considered abnormal pain signaling.

Central Sensitization

A state of nervous system hyperexcitability that leads to increased pain sensitivity.

Transduction

The conversion of tissue injury into an electrical nerve impulse.

Transmission

The process of carrying the pain signal from periphery to the central nervous system.

Perception of Pain

Conscious awareness of pain, influenced by emotional and contextual factors.

Modulation of Pain

The process by which pain signals are amplified or inhibited at various levels of the nervous system.

Endogenous Opioids

Natural pain-relieving substances produced by the body.

Peripheral Sensitization

Increased responsiveness of nociceptors to stimulation following injury.

Allodynia

Pain from a stimulus that does not normally provoke pain.

Hyperalgesia

Increased pain response to a stimulus that is normally painful.

Wind-Up Phenomenon

Progressive increase in pain signal strength with repeated stimulation.

Opioid-Induced Hyperalgesia (OIH)

A condition where increased opioid levels lead to heightened pain sensitivity.

Cognitive Behavioral Methods

Techniques such as distraction and relaxation that alter pain perception.

Multimodal Analgesia

Combining different pain relief methods to enhance pain control and minimize side effects.

Patient-Controlled Analgesia (PCA)

A method allowing patients to self-administer predefined doses of pain medication.

Equianalgesia

The concept of determining equivalent doses of different opioids for managing pain.

Substance Use Disorder (SUD)

A medical condition characterized by compulsive substance use despite harmful consequences.

Tolerance vs Dependence

Tolerance refers to needing higher doses for the same effect, while dependence is the physiological adaptation to a drug.

Naloxone

An opioid antagonist used to reverse opioid overdose.

Gabapentinoids

Medications used for neuropathic pain that modulate calcium channels.

Ketamine

An NMDA antagonist used as an analgesic without respiratory depression.

Nonpharmacologic Pain Management

Methods such as massage, acupuncture, and cognitive techniques to support pain relief.

Pain Assessment Hierarchy

A structured approach for assessing pain when the patient cannot self-report.