14.1 Introduction to Pain
3 min read•june 18, 2024
is a complex experience involving both physical and psychological factors. Understanding the mechanisms behind pain , from to the brain's interpretation, is crucial for effective management. This knowledge forms the foundation for differentiating between acute and .
Recognizing the differences between acute and is essential for tailoring treatment approaches. While serves as a protective mechanism, chronic pain can lead to long-term changes in the nervous system, requiring a multifaceted management strategy that addresses both physical and emotional aspects.
Introduction to Pain
Physiological and psychological aspects of pain
Top images from around the web for Physiological and psychological aspects of pain
Neurostimulation in the treatment of primary headaches | Practical Neurology View original
Is this image relevant?
10.2 Review of Basic Concepts – Nursing Pharmacology View original
Is this image relevant?
Touch and Pain – Introduction to Psychology [Lumen/OpenStax] View original
Is this image relevant?
Neurostimulation in the treatment of primary headaches | Practical Neurology View original
Is this image relevant?
10.2 Review of Basic Concepts – Nursing Pharmacology View original
Is this image relevant?
1 of 3
Top images from around the web for Physiological and psychological aspects of pain
Neurostimulation in the treatment of primary headaches | Practical Neurology View original
Is this image relevant?
10.2 Review of Basic Concepts – Nursing Pharmacology View original
Is this image relevant?
Touch and Pain – Introduction to Psychology [Lumen/OpenStax] View original
Is this image relevant?
Neurostimulation in the treatment of primary headaches | Practical Neurology View original
Is this image relevant?
10.2 Review of Basic Concepts – Nursing Pharmacology View original
Is this image relevant?
1 of 3
- Nociception involves detecting noxious stimuli through (converting stimuli to electrical signals), (propagating signals along nerve fibers), (altering signals in spinal cord and brain), and (conscious experience of pain in brain)
- Pain receptors include (respond to pressure or distortion), (respond to temperature changes), and (respond to chemicals released during tissue damage)
- Pain pathways consist of (transmit signals from periphery to brain) and (modulate signals from brain to spinal cord)
- Psychological factors influencing pain perception include emotional (anxiety, depression, fear), cognitive (attention, expectations, past experiences), behavioral (avoidance, guarding), and social/cultural (family, community, cultural beliefs shaping expression and coping)
- The emphasizes the interplay between biological, psychological, and social factors in pain experience and management
Acute vs chronic pain characteristics
- has sudden onset (usually due to injury, surgery, illness), short duration (<3-6 months), serves protective function (alerts body to potential tissue damage), and resolves as underlying cause heals
- Managed by identifying/treating underlying cause, using non-pharmacological techniques (RICE: rest, ice, compression, elevation), administering (, , ), and monitoring intensity to adjust treatment
- Chronic pain persists beyond expected healing time (>3-6 months), may lack identifiable underlying cause, leads to physical, emotional, social consequences, and involves central nervous system changes (increased pain sensitivity)
- Managed with combining pharmacological (NSAIDs, opioids, , , topical agents) and non-pharmacological treatments (physical therapy, exercise, cognitive-behavioral therapy, relaxation techniques), interdisciplinary pain management programs, focusing on improving function and quality of life rather than complete pain elimination
- Chronic pain can lead to , altering pain processing pathways in the central nervous system
Pain threshold in assessment and treatment
- is minimum stimulus intensity required to produce pain, varies among individuals based on genetics, age, sex, cultural background, and can change over time due to repeated exposure to noxious stimuli or chronic pain conditions
- Understanding patient's helps interpret pain scores and descriptions, identify risk for developing chronic pain
- Patients with lower thresholds may report higher intensities for given stimulus compared to those with higher thresholds
- Tailoring treatment plans based on individual thresholds optimizes management
- Lower threshold patients may require lower analgesic doses or more frequent dosing for adequate relief
- Non-pharmacological interventions (relaxation techniques, cognitive-behavioral therapy) particularly beneficial for lower threshold patients
- Monitoring threshold changes during treatment assesses intervention effectiveness and guides adjustments as needed
Pain Modulation and Altered Pain States
- explains how pain signals can be modulated at the spinal cord level, influencing pain perception
- is an increased sensitivity to pain, often seen in chronic pain conditions
- occurs when normally non-painful stimuli cause pain, a common feature in
- is pain perceived at a location other than the site of the painful stimulus, often due to shared nerve pathways
Key Terms to Review (48)
Acetaminophen: Acetaminophen is a widely used over-the-counter medication primarily used as an analgesic (pain reliever) and antipyretic (fever reducer). It is a key term in the context of drug classifications, pharmacokinetics, pain management, and non-opioid analgesics.
Acute pain: Acute pain is a type of pain that typically lasts for a short duration and has a sudden onset. It often serves as a warning sign of injury or illness and usually resolves once the underlying cause is treated.
Acute Pain: Acute pain is a type of pain that is sudden, severe, and typically short-lived. It is the body's immediate response to tissue damage or injury, serving as a warning signal to prompt protective action and promote healing.
Allodynia: Allodynia is a painful response to a normally non-painful stimulus. It is a type of neuropathic pain that occurs when the nervous system becomes hypersensitive, causing even light touch or mild temperature changes to be perceived as painful.
Analgesics: Analgesics are a class of medications that work to relieve pain without causing a loss of consciousness. They are a fundamental component in the management of pain, which is a central focus in the topics of drug classifications and the introduction to pain.
Anticonvulsants: Anticonvulsants are a class of medications primarily used to prevent and control seizures associated with epilepsy. They work by stabilizing the electrical activity in the brain, reducing the likelihood of abnormal neuronal firing that can lead to seizures. These drugs have applications beyond just epilepsy, as they are also used to treat other neurological and psychiatric conditions.
Antidepressants: Antidepressants are a class of medications primarily used to treat depression, but they can also be effective in managing other mental health conditions, such as anxiety, obsessive-compulsive disorder, and chronic pain. These drugs work by altering the levels of certain neurotransmitters in the brain, which can help improve mood, regulate emotions, and enhance overall well-being.
Ascending Pathways: Ascending pathways refer to the neural structures and circuits that transmit sensory information, such as pain, temperature, and touch, from the body to the brain. These pathways play a crucial role in the perception and processing of various sensations, allowing the central nervous system to interpret and respond to external and internal stimuli.
Biopsychosocial Model: The biopsychosocial model is a comprehensive approach to understanding health and illness that considers the interplay of biological, psychological, and social factors. It provides a framework for examining how these various elements contribute to an individual's overall well-being and the experience of pain.
Black clients: Black clients are patients who identify as Black or African American. Special considerations in pharmacology may be necessary due to genetic, socio-economic, and cultural factors that affect drug efficacy and safety.
Chemoreceptors: Chemoreceptors are specialized sensory cells that detect changes in the chemical composition of the body's internal and external environments. They play crucial roles in various physiological processes, including negative feedback loops, pain perception, and respiratory control.
Chronic pain: Chronic pain is persistent pain lasting longer than three months or beyond the normal healing time. It can be continuous or intermittent and significantly impacts a person's quality of life.
Chronic Pain: Chronic pain is a persistent and long-lasting pain that lasts for more than three to six months, often without a clear underlying cause. It is a complex condition that can significantly impact an individual's quality of life, physical functioning, and overall well-being.
Conduction: Conduction is the process by which pain signals are transmitted along nerve fibers to the central nervous system. It is a crucial step in the body's perception of pain.
Cyclooxygenase: Cyclooxygenase (COX) is an enzyme responsible for the formation of prostanoids, including prostaglandins, from arachidonic acid. It plays a key role in inflammatory and pain responses.
Descending Pathways: Descending pathways refer to the neural circuits that transmit information from the brain to the spinal cord, allowing for the modulation and regulation of various physiological processes, including pain perception. These pathways play a crucial role in the introduction to pain by influencing the transmission and processing of nociceptive (pain) signals.
Gate Control Theory: The gate control theory of pain proposes that the spinal cord contains a 'gate' that can inhibit or facilitate the transmission of pain signals from the body to the brain. This theory suggests that non-painful stimuli can influence the opening and closing of this 'gate', thereby modulating the perception of pain.
Hyperalgesia: Hyperalgesia is a condition characterized by an increased sensitivity to pain, where normally innocuous stimuli can cause a heightened and exaggerated pain response. It is a common feature of various pain disorders and can significantly impact an individual's quality of life.
Idiopathic pain: Idiopathic pain is pain that arises without a known cause, making it challenging to diagnose and treat. It can be chronic and may not respond well to conventional pain management strategies.
Mechanoreceptors: Mechanoreceptors are specialized sensory receptors that detect mechanical stimuli, such as pressure, touch, vibration, and movement, and convert them into electrical signals that the nervous system can interpret. These receptors play a crucial role in the perception of pain, as they are involved in the detection and transmission of nociceptive (pain-related) information.
Modulation: Modulation is the process by which the body alters the perception and response to pain. It involves various neurotransmitters and pathways that either amplify or diminish pain signals.
Multimodal Approach: A multimodal approach refers to the use of multiple treatment modalities or interventions to address a specific condition or problem, particularly in the context of pain management. This approach recognizes that pain is a complex experience that often requires a combination of strategies to effectively manage and alleviate it.
Neuropathic pain: Neuropathic pain is a chronic pain condition resulting from nerve damage or dysfunction within the nervous system. It is often characterized by sensations such as burning, tingling, or shooting pain.
Neuroplasticity: Neuroplasticity is the brain's ability to reorganize itself by forming new neural connections throughout life. It allows neurons in the brain to compensate for injury and disease, and to adjust their activities in response to new situations or changes in their environment.
Neuroplasticity: Neuroplasticity refers to the brain's ability to adapt, change, and reorganize itself in response to new experiences, learning, and environmental demands. It is a fundamental property of the nervous system that allows the brain to modify its structure and function throughout an individual's lifetime.
Nociception: Nociception is the neural process of encoding and processing noxious (painful) stimuli. It involves the detection of harmful stimuli by sensory receptors called nociceptors and the transmission of pain signals to the central nervous system.
Nociceptive pain: Nociceptive pain is a type of pain caused by damage to body tissue. It is typically described as sharp, aching, or throbbing pain.
Nociceptors: Nociceptors are specialized sensory receptors that detect signals from damaged tissue or the threat of damage and transmit pain signals to the central nervous system. They play a crucial role in the body's ability to perceive pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce inflammation, pain, and fever without the use of steroids. They inhibit cyclooxygenase enzymes (COX-1 and COX-2), which are involved in the production of prostaglandins.
NSAIDs: NSAIDs, or Non-Steroidal Anti-Inflammatory Drugs, are a class of medications that are widely used to reduce inflammation, alleviate pain, and lower fever. They work by inhibiting the production of prostaglandins, which are key mediators of the inflammatory response. NSAIDs are commonly employed in the management of various conditions, including arthritis, menstrual cramps, headaches, and post-operative pain.
Opioid Analgesics: Opioid analgesics are a class of medications used to relieve severe pain by binding to opioid receptors in the brain and spinal cord. They are often used in emergency settings for acute cardiac events where pain management is critical.
Opioids: Opioids are a class of drugs that act on the opioid receptors in the body, producing a wide range of effects including pain relief, sedation, and euphoria. They are commonly used in the management of acute and chronic pain, and their use is a critical aspect of pharmacology, interdisciplinary teams, and nursing practice.
Opioids are also classified as a type of drug prototype and their pharmacokinetics and pharmacodynamics are crucial in understanding their therapeutic and adverse effects. Additionally, the introduction and management of pain, a significant health concern, is closely tied to the use of opioid analgesics.
Pain: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It serves as a warning signal to the body that something is wrong.
Pain assessment: Pain assessment is the systematic evaluation of pain, including its intensity, location, and impact on daily activities. It helps guide appropriate pain management strategies.
Pain threshold: Pain threshold is the minimum intensity at which a person begins to perceive a stimulus as painful. It varies between individuals due to genetic, psychological, and environmental factors.
Pain Threshold: Pain threshold is the minimum intensity of a stimulus that is perceived as painful. It is the point at which a sensory experience transitions from discomfort to pain and represents an individual's tolerance for pain stimuli.
Perception: Perception is the process by which sensory information is interpreted and recognized by the brain. It plays a crucial role in how pain is experienced and managed.
Perception: Perception is the process by which individuals organize and interpret their sensory impressions in order to give meaning to their environment. It involves the recognition and interpretation of sensory information from the surrounding world. Perception is a crucial aspect of the experience of pain, as it shapes how individuals subjectively interpret and respond to pain stimuli.
Referred pain: Referred pain is a type of pain perceived at a location other than the site of the painful stimulus. It often occurs when nerves from various parts of the body converge on their way to the spinal cord.
Referred Pain: Referred pain is a phenomenon where pain is perceived in a location different from the actual source of the pain. It occurs when pain signals from one part of the body are misinterpreted by the brain as originating from another area.
Somatic pain: Somatic pain arises from the skin, muscles, and soft tissues. It is usually well-localized and described as sharp or throbbing.
Substance P: Substance P is a neuropeptide involved in the transmission of pain signals to the central nervous system. It binds primarily to the neurokinin-1 (NK1) receptor, playing a crucial role in pain perception.
Thermoreceptors: Thermoreceptors are sensory receptors that detect changes in temperature within the body or in the environment. They play a crucial role in the regulation of body temperature and the perception of thermal stimuli, which are important for both the negative feedback loop of thermoregulation and the introduction to pain.
Transduction: Transduction is the process by which a painful stimulus is converted into an electrical signal in the nervous system. This is the first step in the pain pathway leading to perception.
Transmission: Transmission in pharmacology refers to the process by which pain signals are relayed from peripheral nerves to the central nervous system. This involves neurotransmitters and synaptic pathways.
Transmission: Transmission refers to the process by which infectious agents, such as bacteria, viruses, or fungi, are transferred from one individual or source to another. It is a crucial concept in understanding the spread and control of various infectious diseases, including bacterial, viral, and fungal infections, as well as the mechanisms involved in pain transmission.
Visceral pain: Visceral pain is a type of pain that originates from the internal organs and is often described as deep, aching, or cramping. It is usually poorly localized and can be associated with referred pain.
Wong–Baker FACES pain rating scale: The Wong–Baker FACES pain rating scale is a visual tool used to help patients, especially children, communicate their level of pain. It consists of six faces ranging from a happy face at 0 (no pain) to a crying face at 10 (worst pain).