MAIN IDEAS
100
an unpleasant sensory and
emotional experience associated with
actual or potential tissue damage or
described in terms of such damage.
Pain
200
At any one time __% of people have
pain for more than 3 months (Pain
2001)
20%
300
The amount of pain experienced relates to the amount of tissue damage sustained
TRUE or FALSE
FALSE!
The amount of pain experienced does
not necessarily relate to the amount of
tissue damage sustained
400
When father experiences labor pain
Couvade syndrome
500
The context of pain
What can enhance fear?Can providing information to the pt. before surgery reduce pain?
Lack of knowledge enhances fear
Deep injuries that patients cannot see
and lack of knowledge increase the
threat of pain
More information provided to a patient
before surgery reduces pain
medication needed
600
Phantom pain
Where is the pain?
Can it itch or tingle?
Can the pain get better with stress?
Pain memory- more phantom pain when
there was pain before _______ (Pain
1985)
Experience of pain in a body part that
does not exist
Can itch, tingle and hurt
Pain can worsen under stress
Pain memory- more phantom pain when
there was pain before amputation (Pain
1985)
700
Nociception
The neural processes of encoding and processing what?
What is danger reception?
The neural processes of encoding and
processing noxious stimuli (an actual or
potential tissue damaging event) (Pain
2008)
Danger reception- activation of neurons
in the tissues that respond to danger
stimuli sending a prioritized alarm to the
spinal cord then brain
800
Response to input
The brain makes a value judgment
regarding what?
What systems does the brainstem call on to respond?
The brain makes a value judgment
regarding inputs and responds
The brain calls upon many systems to
get you out of trouble
◦ Muscle system: run away, splint injured limb
◦ Sympathetic system: sweating, blood
distribution
◦ Immune system
◦ Endocrine
◦ Systems at their best for short periods
900
Altered central nervous system
alarms
What is Allodynia?
Hyperalgeisa: increased sensitivity to
pain, which may be caused by damage
to nociceptors or peripheral nerves.
Allodynia: meaning "other pain", is a
pain due to a stimulus which does not
normally provoke pain and can be
either thermal or mechanical.
1000
Persistent pain
During persistent pain, the brain is being told what?
During persistent pain the brain is
being told there is more danger at the
tissues than there actually is
1100
Cortisol
Also know as what?
is a steroid hormone or glucocorticoid
produced by the ________
Often known as the stress chemical->
protects you when you are challenged
and slows down what?
Increased cortisol is linked to what?
Cortisol production changes during the
day: best in the __ and slowest in __:
Also known as hydrocortisone, is a
steroid hormone or glucocorticoid
produced by the adrenal gland
Often known as the stress chemical->
protects you when you are challenged
and slows down the body processes
which are not needed for immediate
protection
Increased cortisol: linked to decreased
memory, slow healing, depression and
decline in physical performance
Cortisol production changes during the
day: best in the am and slowest in pm:
maintain inflammation- patients may
have more pain in the evening when
cortisol levels are down