Purpose of/benefits of pain – disadvantages of not feeling pain (examples)
Some pain is critical for survival
-medical consequences: critical for survival.
-pain is the symptom most likely to lead an individual to seek treatment. Even people that don’t
like doctors when they are in pain will go and see the doctor.
Disadvantages of not feeling pain is that a person can get further injured without even knowing it
because the pain receptors are not there. An example would be a person who has diabetes and has
no pain receptors in the leg the example of the grandpa whose grandson put a nail in their shoe
and had to get a toe amputated because they never felt the nail.
Medical significance of pain – misunderstandings between patient and provider
-pain can be a source of misunderstanding between a patient and the medical provider.
-it doesn’t tell the doctor what the disease processes is.
-Often doctors undertreat it.
-For the patient, the pain is the problem.
-Doctor may not know if the person is in pain or if the patient is just seeking medication.
The Significance of Pain
Lower back pain – 70-80% of people experience medically significant lower back pain in their
lifetime.
Headaches- 60 million people in the U.S. have chronic headaches.
Arthritis- 54 million people in the U.S. have daily arthritis pain.
Prevalence of pain, common pain conditions, costs of pain treatment
Pain is very prevalent and costly in the U.S. and around the world. More than 30 billion dollars
spent in prescription medication and another billion on over the counter medication loss. Loss of
productivity and disability payments spent as well.
Effects of mood on pain, interaction of pain/mood/behaviors (“pain cycle”)
Psychological Significance:
-depression and anxiety worsen the experience of pain.
, Pain cycle
Pain
Depression Fatigue
Withdrawal
Pain is a psychological experience.
The amount of pain that occurs is the result of the meaning that’s attached to the pain
-pain is influenced by the context in which it is experienced.
-pain has a cultural component.
Cultural, psychological, contextual influences on pain interpretation
Measurement of pain – self-report, behavioral indicators, difficulties of, experimental work on
the neurobiology of pain
-Verbal reports- what we rely the most on
language that is used-throbbing, dull, aching, pinching, etc.
-Pain behavior
-behavior that arises as a manifestation of chronic pain.
- assesses how pain has disrupted the lives of patients (impairment).
Are they limping or guarding?
Rheumatoid arthritis joints become degenerative.
Experimental technique for measuring pain.
- In the experiment, they used and objective measure of a particular type of paint.
- They gave the participants a thermal stimulus. A probe that held onto and they heated
it up until the person reported pain. It was painfully hot.
- Used an fMRI technique to isolate a “pain signature” of activation in specific brain
regions.
- 90% accuracy in distinguishing pain from other forms of stimuli, recall of pain. Or
anticipation of pain.
Physiology of pain
Pain is a protective mechanism accompanied by motivational and behavioral responses.
- Sometimes the responses to pain cause more problems (e.g., compensatory behaviors)
Nociception – definitions, types (mechanical, thermal, polymodal/chemical)
Three kinds of pain perception
Mechanical nociceptor:
- Mechanical damage to body tissue. Riding a bicycle and land on the road with your
knees.
Thermal damage
- Damage due to temperature exposure.
Polymodal nociceptor:
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