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1. Pain Control Theories
3. Pain Anatomy Review Primary Afferent Fibers
1st Order Neurons
Dorsal Horn
4. Pain Anatomy Review Primary Afferent Fibers
1st Order Neurons
Dorsal Horn
Spinothalamic Tract
5. Gait Control Theory Pain can be altered by blocking impulses within pathways
Stimulate A-beta stimulates substantia gelatinosa
A-beta’s are faster than A-delta and C fibers
How does this work?
Gate Open
Gate Closed
6. Endogenous Pain Control Ascending Influence on Pain Control
Similar to Gate Control
A-beta triggers release of Enkephalin
Inhibits Substance P at junction between 1st and 2nd order neurons
7. Endogenous Pain Control Descending Influence on Pain Control (Central Biasing)
Stipulates that higher brain centers can modulate pain
PAG and RN
Dorsal Lateral Tracts
Enkephalin Interneurons
Release of serotonin
Past experience, emotional influences and sensory perception
8. Endogenous Pain Control Beta-Endorphin Mediated Model
What is Endorphin?
Found in hypothalamus and periaqueductal gey matter
Activation of small diameter fibers
Release of BEP
9. Acute vs Chronic Pain Acute Pain
Definition
Pain of recent or sudden onset
Function
Primary Hyperalgesia
Secondary Hyperalgesia
Pain-Spasm-Pain Cycle
10. Acute vs Chronic Pain Chronic Pain
Definition
Pain of long duration, often associated with anguish, apprehension, depression, hopelessness
Consider neurophysiologic and psychologic factors
Four Levels of Chronic Pain
Nociception
Pain
Suffering
Pain Behaviors
11. Other Types of Pain MFPS
Chronic Pain
No single cause
S/S
12. Pain Management Must consider physiological, behavioral and cognitive
Physical
Modalities
Behavioral
Reducing anxiety
Explain treatments
Cognitive
Central Biasing
Relaxation techniques, motivation etc