Physio Exam 2 Pain Chapter

Gate Control Theory

• Large Fibers and Small Fibers

• Takes place in the spinal cord

• Large fibers are going to inhibit the SG (closes the gate) cells, the SG cells inhibit the the T-Cells, the T-cells then go to the brain and signal that there is no pain

• Small fibers are going to stimulate the SG cells (open the gate), the SG cells are then going to stimulate the T-Cells, the T-cells then go to the brain and signal that there is pain somewhere

• The brain can also inhibit SG cells (close the gate), and then the T-cells are inhibited and signal that there is no pain

TENS unit

• Sticky patches that provide electrical signatures to the area of pain

• A theory of how it works is that the electrical stimulation hits the large fibers, inhibits the SG cells, and therefore inhibits the T-Cells signaling to the brain that there is no pain

Endorphins

natural morphine for the body

Endogenous

• Internal endorphins

Exogenous

• external endorphins

Why Placebo Effect Happens

The reason placebo effects occur is that when people are told a pill they are given will affect something, a person gets excited, and therefore endorphins take over

The evidence behind this theory is that when Naloxone is given to the patient, it blocks the site of the endorphins and therefore stops the placebo effect

Pain

Can signal potential of actual pain that is associated with emotional and or sensory experience of potential or actual tissue damage

Potential Versus Actual

pain receptors signal pain when you could cause damage

EX: pain receptors going off when you have the potential of actually burning yourself

Sensory versus Emotional

It hurt really bad but not serious damage was done

Ex: knee Hyperextension

Sensory - Throbbing, Stabbing, Hot, Dull, Sharp

Emotional - horrific, torturing, very bad

Cognitive aspects/ differences in a persons pain reception

• expectations

• shifting attention

• Individual differences

Expectations

If you know what to expect or have gone through the pain before you will show less pain/faster recovery

EX: doctor explaining what could happen/what is normal makes the pain easier and faster recovery to occur

Placebo Effect

take this and you’ll feel better then you feel better even if the pill/medicine doesn’t do anything

Shifting Attention

you move your attention away from the pain and it sorta blocks it which makes you feel less pain

Individual Differences

Athletes versus Non-athletes

Sticking the foot in the ice water

Different people experience pain in different ways because of their tolerance

James Pokorney

• 3rd degree burns over 42% of his body

• Very easy for bacteria to get in, so they wrap and rewrap the gauze

• Played a video game to distract from the pain

• barely felt the bandages being removed

• Shifting attention

Nepalese —> Sherpas

They are the pack horses for climbing MNT. Everest they expereince way less pain than the regular person climbing the mountain becuase of individual differences