What are the 4 processes involved in pain?
Pain Processes. Figure 7-1 illustrates the major components of the brain systems involved in processing pain-related information. There are four major processes: transduction, transmission, modulation, and perception. Transduction refers to the processes by which tissue-damaging stimuli activate nerve endings.
What chemicals are involved in the pathogenesis of pain?
Other chemicals, such as bradykinin, prostaglandins, and leukotrienes, are synthesized by enzymes activated by tissue damage (Armstrong, 1970; Ferreira, 1972; Moncada et al., 1985; Vane, 1971). All of these pain-producing chemicals are found in increased concentrations in regions of inflammation as well as pain.
What is the role of physiological factors in enhancing pain?
Although it is well known and well accepted that various psychosocial factors may enhance pain, the role of several physiological processes in amplifying and maintaining pain is perhaps not adequately taken into account when assessing patients' complaints. Sensitization Tissue damage initiates a variety of processes that sustain and amplify pain.
Which physiologic response is not usually associated with acute pain?
A physiologic response not usually associated with acute pain is: Decreased production of coritsol ASSOCIATED physiologic responses include: altered insulin response and increased metabolic rate Chronic pain may be described as: prolonged in duration An example of chronic benign pain is: low back pain
What are the 4 phases of pain?
The neurophysiologic underpinnings of pain can be divided into four stages: transduction, transmission, pain modulation, and perception.
What are the 4 processes of nociception?
Nociception involves the 4 processes of transduction, transmission, perception, and modulation.
What are the factors influencing pain?
The perception of, expression of, and reaction to pain are influenced by genetic, developmental, familial, psychological, social and cultural variables. Psychological factors, such as the situational and emotional factors that exist when we experience pain, can profoundly alter the strength of these perceptions.
What are the 4 types of nociceptors?
These primary afferent neurones, also known as nociceptive neurones (read more about nociception), are specialised neurones that can be divided into 4 main modalities; mechanonociceptors (Pressure), Thermal Nociceptors, Chemically sensitive nociceptors or polymodal nociceptors.
What is the first step in pain process?
Nociceptive pain occurs in 5 phases: 1) Transduction, 2) Conduction, 3) Transmission, 4) Modulation, 5) Perception. Transduction begins when peripheral terminals of nociceptive C fibers and A-delta (Aδ) fibers are depolarized by noxious mechanical, thermal, or chemical energy.
What are the 3 mechanisms of pain?
Mechanisms include hyperexcitability and abnormal impulse generation and mechanical, thermal and chemical sensitivity.
What is the treatment of pain?
pain medicines. physical therapies (such as heat or cold packs, massage, hydrotherapy and exercise) psychological therapies (such as cognitive behavioural therapy, relaxation techniques and meditation) mind and body techniques (such as acupuncture)
What are the pain pathways?
The ascending pathways that mediate pain consist of three different tracts: the neospinothalamic tract, the paleospinothalamic tract and the archispinothalamic tract. The first-order neurons are located in the dorsal root ganglion (DRG) for all three pathways.
What are the biological factors that influence the perception of pain?
Changes in brain regions involved in the processing of painful stimuli, such as the prefrontal cortex, primary and secondary somatosensory cortex, hippocampus, anterior cingulate, insula, and thalamus, may in part be responsible for the changes in pain perception over the lifetime.
What are the receptors for pain?
The pain receptors are nociceptors. They are known to exist in muscle, joints, and skin. Each nociceptor has selective sensitivity to mechanical (muscle-fiber stretching), chemical (including lactic acid), and thermal stimuli.
What causes nociceptive pain?
Nociceptive pain is a type of pain caused by damage to body tissue. Nociceptive pain feels sharp, aching, or throbbing. It's often caused by an external injury, like stubbing your toe, having a sports injury, or a dental procedure.
How do nociceptors respond to pain?
These receptors relay information to the CNS about the intensity and location of the painful stimulus. Nociceptors respond when a stimulus causes tissue damage, such as that resulting from cut strong mechanical pressure, extreme heat, etc.
What are the different types of pain?
There are many different types and causes of pain, and these can be grouped into eight different categories to help with pain management: Acute pain. Chronic pain.
What is breakthrough pain?
Breakthrough pain is a sudden, short, sharp increase in pain that occurs in people who are already taking medications to relieve chronic pain caused by conditions such as arthritis, cancer, or fibromyalgia.
How long does chronic pain last?
Chronic pain is pain that has persisted for longer than six months and is experienced most days. It may have originally started as acute pain, but the pain has continued long after the original injury or event has healed or resolved. Chronic pain can range from mild to severe and is associated with conditions such as:
What is the pain that feels like it is coming from one particular location?
Referred pain. This is pain that feels like it is coming from one particular location, but is the result of an injury or inflammation in another structure or organ. For example, during a heart attack, pain is often felt in the neck, left shoulder, and down the right arm.
What is soft tissue pain?
Soft Tissue Pain. This is pain or discomfort that results from damage or inflammation of the muscles, tissues, or ligaments. It may be associated with swelling or bruising and common causes include: Back or neck pain.
Why do I feel nerve pain?
Many people with chronic nerve pain also develop anxiety or depression. People with neuropathic pain are often very sensitive to touch or cold and can experience pain as a result of stimuli that would not normally be painful, such as brushing the skin. Common causes of nerve pain include: Alcoholism.
When was the pain ladder invented?
However, this “Pain Ladder” was developed in 1986, and other medications that are not analgesics can also be effective at relieving pain. In addition, opioids should only be used for certain types of pain, because of their risk of addiction.
How much of the population experiences chronic pain?
It is estimated that about 10% of the general population experiences chronic pain at any given time. 1 This paper explores the genetic influences on specific human musculoskeletal pain perception. From a Darwinian perspective, nociceptive pain is impossible to eliminate nor is it desirable to do so.
What is the second layer of pain?
The second layer are the variations in nociception. The third is variations in the transmission of these signals. The fourth is the response that the pain transmission produces. The fifth is the chain reaction of system that has gone awry and causes chronic pain. The sixth is the interpretation of an individual’s pain.
What hormones are released from the adrenal gland in response to stress?
Catecholamine-sympathomimetic hor-mones—mainly epinephrine, norepinephrine, and dopamine —are released from the adrenal gland in response to stress, including that of severe pain. A sustained elevation in catecholamines is also associated with chronic musculoskeletal pain conditions. In fact, pain caused by an injury in one part of the body can cause musculoskeletal pain in another via the catecholamine system. Pain is mediated through both supraspinally-organized descending pathways and spinal mechanisms. Abnormalities in catecholamine physiology are associated with diminished activity of catechol-O-methyltransferase (COMT), an enzyme that acts centrally and peripherally to metabolize catecholamines. Studies have shown that elevated catecholamine levels promote persistent pain states. 5 COMT inhibition showed increased pain sensitivity to hyperalgesia (increased sensitivity to pain) and allodynia (non-painful stimuli that causes pain).
Why is nociception important?
Nociception is essential for survival and, if a variation in a pain mechanism gene alters the function of a nociception-related molecule, the survival rate would be diminished. For instance, without pain mechanisms, people would not recognize the danger of leaving their hand on a hot stove.
What influences basal pain sensitivity?
Genomic variations influence basal pain sensitivity and the likelihood of developing chronic pain so it is logical that the future of medicine is to provide more focused treatment based on a person's genetic code.
Is pain a medical condition?
It provides a scientific foundation to view pain as just another medical condition that is mild, moderate, or severe and, from a practical standpoint, gives us fodder for patient education by confirming that a wide variety of treatments are meritorious and may have to be simultaneously administered.
Is pain sensitivity genetic?
Evidence of genetic influences on pain sensitivity in humans has yet to be clinically applied. Polymorphisms—the normal differences in DNA sequences among individuals in a population—of receptors, transporters, metabolizing enzymes, and targets of pharmacotherapy are under investigation.
What is the process of releasing chemicals that reduce pain signals?
Modulation involves the release of chemicals, such as endorphins and serotonin, that reduce the transmission of pain signals. The concepts of pain threshold (when a sensation becomes "painful") and pain tolerance (the amount of pain a person endures) also fit into this stage.
What are the different types of pain?
Types. Somatic Pain. Visceral Pain. Phases. Chronic Nociceptive Pain. Treatment. Nociceptive pain is a type of pain caused by an injury, physical pressure, or inflammation of some part of the body. There are two types of nociceptive pain: Somatic, which originates in your arms, legs, face, muscles, tendons, and superficial areas of your body, ...
What is the difference between somatic and visceral pain?
Another difference between somatic and visceral pain is that visceral pain may be associated with other symptoms like nausea, vomiting, or jitteriness, which less commonly occurs with somatic pain. 2 .
What is the best treatment for nociceptive pain?
Of course, besides medications, there are a plethora of other therapies used to treat nociceptive pain, with some examples including: 1 Physical therapy 2 Alternative treatments like biofeedback or acupuncture 3 Hot and cold therapy 4 Surgery (for example, for pain from a visceral problem, like appendicitis)
How do nociceptors detect physical damage?
When nociceptors detect physical damage to your body, they create electrical signals. The signals travel to your spinal cord, which then sends the message up to the brain. This process occurs rapidly, involves four key steps, and is the same for both somatic and visceral nociceptive pain: Transduction: Tissue injury (bumping your arm on a table) ...
What does it mean when you feel a visceral pain?
You might feel visceral pain if you have a stomach infection, constipation, or something more serious such as internal bleeding or cancer.
How do opioids and antidepressants work?
On the other hand, opioids and antidepressants target phase four (modulation), so they work by inhibiting the pain signals that are sent along the nerve pathway. Of course, besides medications, there are a plethora of other therapies used to treat nociceptive pain, with some examples including: Physical therapy.
What are the physiologic responses of acute pain?
A physiologic response not usually associated with acute pain is: Decreased production of coritsol. ASSOCIATED physiologic responses include: altered insulin response and increased metabolic rate.
What is a nursing plan of care for pain management?
A nursing plan of care for pain management should include: -altering factors that influence the pain sensation. -determining responses to the patient's behavior toward pain. -selecting goals for nursing intervention. Pain in the elderly requires careful assessement, because older people:
What are the advantages of intraspinal infusion?
The advantage of using intraspinal infusion to deliver analgesics is: -reduced side effects of systemic analgesia. -reduced effects on pulse, respirations, and blood pressure. -reduced need for frequent injections.
What are the side effects of opioid analgesics?
are more sensitive to drugs. The most serious side effects of opioid analgesic agents is: respiratory depression. A preventive approach to pain relief with nonsteroidal anti-inflammatory drugs (NSAIDs) means that the medication is given: before the pain is experienced.
How does cutaneous stimulation help with pain?
Cutaneous stimulation is helpful in reducing painful sensations, because it: -provides distraction from the pain source and decreases awareness. -releases endorphins. -stimulates large-diameter nerve fibers and reduces the intensity of pain. Pain can be defined according to its: duration, location, and etiology.
How to manage anxiety during anticipation of pain?
A nursing measure to manage anxiety during the anticipation of pain should include: -focusing the patients attention on another problem. -teaching about the nature of the impending pain and associated relief measures . -using an anxiety-reducing technique, such as desensitization.
Is enkephalin the same as opioids?
TRUE statements include: their release inhibits the transmission of painful impulses. they are endogenous neurotransmitters structurally similar to opioids.