Acute Pain

Pain that is generally RAPID IN ONSET, varies intensity from mild to severe.

Protective in nature (serves to warn you of tissue damage or organic disease)

Chronic Pain

Pain that may be limited, intermittant, persistant but lasts BEYOND THE NORMAL HEALING PROCESS.

(in other words, ongoing)

(in) Remission

When the disease or condition is present but without symptoms.

(persons with chronic pain usually have the pain go into remission)

Exacerbation

When symptoms (or in this case, pain) REAPPEARS

Chronic Malignant Pain

Pain associated with cancer or other progressive disorders.

Cutaneous Pain

Pain that is superficial and usually involves the SKIN OR SUBCUTANEOUS TISSUE.

Somatic Pain

DEEP pain associated with TENDONS, LIGAMENTS, BONES, BLOOD VESSELS and NERVES

Visceral Pain

Pain that is POORLY LOCALIZED and originates in BODY ORGANS IN THE THORAX, CRANIUM and ABDOMEN.

(visceral means "guts")

Referred Pain

Pain that originates in one part of the body but is perceived in another area distant from its point of origin.

Neuropathic Pain

Pain that results from an injury to or abnormal functioning of PERIPHERAL NERVES or the CENTRAL NERVOUS SYSTEM (CNS).

"Neuro" = nerves

"Pathic" = Disease, pain

Intractable Pain

Pain that resists therapy and persists despite a variety of interventions.

("won't withdraw")

Phantom (limb) Pain

Pain associated with an amputated limb where the nerves and pain receptors are obviously absent.

Psychogenic Pain

Pain for which a physical cause can't be identified.

("generated in your psych" vs. your body)

True or False: Pain from a mental event can be just as intense as pain resulting from a physical event.

TRUE

What are behavioral pain responses?

Give some examples

Pain responses that are VOLUNTARY in nature.

Moving away from the painful stimuli (taking your hand away from a hot stove)

Grimacing, moving, crying

Restlessness

Protecting the painful area and refusing to move (like holding onto your groin and lying on the ground)

What are physiologic responses to pain?

Can you give some examples?

They sympathetic (fight or flight) responses

Examples include:

Increased blood pressure

Pupil dilation

Nausea/Vomiting

Fainting

Prostration

Rapid and irregular breathing

What are affective responses to pain?

Can you give some examples?

They are PSYCHOLOGICAL responses.

Examples:

Exaggerated weeping & restlessness

withdrawal, stoicism, anxiety, depression, fear, anger, Anorexia, fatigue, hopelessness, powerlessness

What are the four stages of the pain process?

Transduction

Transmission

Perception

Modulation

Transduction

The activation of pain receptors.

Conversion of painful stimuli into electrical impulses

What are nociceptors?

Peripheral nerve fibers that transmit pain.

Neurotransmitters

Substances that either excite or inhibit target nerve cells.

What is "Transmission" of pain?

When pain sensations from the site of injury or inflammation are conducted along pathways to the spinal cord and then onto the higher centers in the central nervous system.

Think "transmission of power along a power line".

What is "Perception" of pain?

The sensory process that occurs when a stimulus for pain is present.  Includes the person's INTERPRETATION of pain.

You perceive it.

"Damn! That stovetop is HOT!!!"

Pain Threshold

The LOWEST INTENSITY of a stimulus that causes the subject to recognize pain.

What is MODULATION of pain?

The process by which the sensation of pain is inhibited or modified.

Neuromodulators

Substances that inhibit or moderate pain in the modulation process.

What are ENDORPHINS?

They're opioid neuromodulators (pain inhibiting or moderting chemicals) produced at the neural synapses at various points along the CNS pathway.

What is the most powerful endorphin?

Dynorphin

(think "DYNAMIC")

What are Enkephalins?

(as opposed to Endorphins?)

ENKEPHALINS are neuromodulators that are less potent and endorphins. Found in the brain and dorsal horn of the spinal column.

Thought to inhibit Substance P.

Placebo

Any medication or procedure that may produce an effect because of its implicit or explicit intent and not because of its specific chemical properties.

The placebo effect can work because the patient believes it will work (they're not told it's a placebo).

The word is Latin for "I shall please" (placate)

Analgesic

A pharmaceutical agent that relieves pain.

Physical Dependence

A phenomenon in which the body physiologically becomes accustomed to an opiod and suffers withdrawal symptoms if the opiod is removed or rapdily decreased.

Tolerance

Occurs when the body becomes accustomed to the opiod and needs a larger dose each time for pain relief.

Addiction

A pattern of compulsive opioid use for for any means other than pain control.

What type of drugs are the preferred choice for mild to moderate pain?

NSAID drugs

(non-steroidal anti-inflammatory drugs such as acetominophen)

Adjuvant Drugs

Drugs that are typically used for other purposes but are also used to enhance the effect of opioids by providing additional pain relief.

May also provide relief from opioid side effects or lessen anxiety of pain experience.

Pain Tolerance

The point beyond which a person is no longer willing to endure pain.

Gate Control Theory of Pain

describes the transmission of painful stimuli and recognizes a relationship between pain and emotions.

Simply put, when there is an overwhelming amount of pain (too much for the brain to process) the "gate" that allows the pain message to travel is shut off.