BioPsychoSocio
what is the biopsychosocial model for pain
argues that pain is a personal experience that emerges from a dynamic interplay between biological, psychological, and social factors
Pain and __________ are different phenomena. Pain serves as an ______ role based on multiple factors
nociception, adaptive role
what are 3 mechanisms of the human pain experience
Input Mechanism: nociception, environment, PNS
Processing Mechanism(brain): sensory, cognitive, emotional
Output Mechanisms (reaction/response): interpretation, pain, systemic response
what were the 3 waves of opioid overdose deaths
1990s: rise in prescription overdose deaths
2010: rise in heroin overdose
2013: rise in synthetic opioid overdose deaths (fentanyl)
what started the opioid crisis
in the 1980s HIV epidemic drew attention to pain, in the 90s oxycontin approved and spread as nonaddictive miracle pain relieving drug
what are biological factors of pain
genetics, neurochemistry, immune responses, nociception, drug effects, physiological response
Through __________,individuals learn the concept of pain, verbal description is only one of several ways to _______ pain
experience, express
compare and contrast acute and chronic pain
Acute pain is immediate following an injury such as a mechanical or temperature injury. This pain tends to be more sharp or shooting pain. Chronic pain is a pain that lasts for a long time, approximately 3 months or more
if a patient takes opioid medication for ___ days, their chance of still taking the medication one year later jumps to ___%
31, 30%
1 in 7 patients (13.5%) will still be taking the opioid medication ________later after initially taking a prescription for __ days straight
one year, 8
what are psychological factors of pain
learning, emotions, thoughts, beliefs, attitudes, memory, perceptions, stress management, fear, catastrophizing
what are the dimensions of pain
physiologic: location, onset, duration, etiology, syndrome
Sensory: intensity, quality, pattern
Affective: mood, anxiety, depression, well-being
Cognitive: meaning, view of self, coping skills and strategies, previous treatments, attitudes and beliefs
Behavioral: communication, interpersonal interaction, physical activity, pain behaviors, medications, sleep
Sociocultural: cultural background, family and social life, work and home responsibilities, recreation and leisure, environmental factors, attitudes and beliefs
steps of acute pain
1. pain felt, noxious stimuli 2. dull throbbing, 3. personal experience of pain (multifactorial, environment/experience based)
routine use of opioids in the ER and with dentists may set up a person for ________ and _______
long term use, addiction
True or False: inflammation is needed to repair tissues
True!
what are social factors for pain
social support, family, medical care, socioeconomic status, physical exercise, culture, society, occupation
what disparities exist among population groups
older adults: over 60% of older adults >65 yrs report persistent pain
Ethnic: non hspanic white adults are 23.6% more likely to have persistent pain
Children: 1 in 6 children 54% experienced pain in last 3 months, 25% report persistent pain
Geography: Australia 1 in 5 struggle with persistent pain, 19% Europeans experience mod to severe persistent pain
Gender: > women, higher correlation w/ depression, higher rates of widespread pain and HA
Socioeconomic: persistent pain impacts large portion of adult Australian population associated with markers of social disadvantage
what are types of stimulus for pain
mechanical, temperature, chemical (noxious stimuli)
COVID-19 pandemic data indicates ____________
significant increase in opioid use
name the unmyelinated nociceptor (nerve) fibers, class, and their dysfunction
small fibers:
C fibers: sensory - burning pain and abnormal heat sensation
C fibers: autonomic - abnormal sweating, b/b and sexual dysfunction, abdormal BP control
pain is always a _________ experience, a persons report of pain should be __________
personal, respected
how much US money is soent on annual basis for pain
$560-635 billion
name the Myelinated nociceptor (nerve) fibers, class, and their dysfunction
- Large:
alpha motor neurons: motor - weakness, atrophy, cramps, fasciculations
beta fibers: sensory - abnormal proprioception, vibration and touch sensation
- small:
delta fibers: sensory - deep and lancinating pain, abnormal cold and pressure sensation
what can PTs do to help persistent pain?
education: general public on direct access to PT, pts on affects of opioids - how PT can help - modalities available, understanding chronic pain and the biopsychosocial model, recommending other help such as therapy if and where needed
describe the pathway of inflammation
tissue damage, inflammatory mediators released into tissue, these stimulate C fibers, which then release other mediators called neuropeptides, these neuropeptides release: mast cells and histamine, which then stimulate dilation of local blood vessels, further helping release More inflammation into area and further stimulate C fibers