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The Nature & Symptoms of Pain

The Nature & Symptoms of Pain. Chapter 11. Qualities & Dimensions of Pain. Organic pain vs. Psychogenic pain Acute vs. Chronic Pain. Qualities & Dimensions of Pain. Chronic pain Benign vs. Malignant Continuous vs. Episodic Types Chronic/recurrent Chronic/intractable/benign

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The Nature & Symptoms of Pain

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  1. The Nature & Symptoms of Pain Chapter 11

  2. Qualities & Dimensions of Pain • Organic pain vs. Psychogenic pain • Acute vs. Chronic Pain

  3. Qualities & Dimensions of Pain • Chronic pain • Benign vs. Malignant • Continuous vs. Episodic • Types • Chronic/recurrent • Chronic/intractable/benign • Chronic/progressive

  4. Assessing Pain • Self-Report Methods • Questionnaires • Behavioral Assessment • Physiological Measures

  5. Personal & Social Experiences and Pain • Learning • Emotions

  6. Physiology of Pain Perception • Noxious stimulation release of algogenic substances at the site • e.g., serotonin, histamine, bradykinin • Algogenic substances promote immune system activity (inflammation) • Inflammation activates free nerve endings signaling pain • Free nerve endings: nociceptors

  7. Physiology of Pain Perception • Afferent peripheral fibers • A-delta fibers • C fibers

  8. Pain Without Apparent Physical Basis • Types • Neuralgia • Causalgia • Phantom Limb Pain

  9. Theories of Pain • Specificity Theory • Pattern Theory • Gate Control Theory

  10. Gate Control Theory Brain Small A-delta & C fibers + + + Substantia Gelatinosa “The Gate” Transmission cells (T cells) - - + Large A-beta fibers

  11. Opiates inhibit inhibitory neurons of PAG Theories of Pain Basbaum & Field’s Descending Analgesic Pathway Periaqueductal Grey disinhibition + Interneurons Raphe Nucleus - Spinal Cord Incoming Pain Signals Ascending Anterolateral Pathway to brain

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