Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
What are examples of peripheral, noiceptive pain?
|
Acute pain due to injury
OA RA Cancer pain |
|
|
What are examples of pain due to peripheral neuropathies?
|
DM neuropathic pain
Post herpeticneuralgia |
|
|
What are some examples of central neuropathic/centralized pain?
|
Fibromyalgia
IBS TMJD Tension headaches |
|
|
What type of a person is most likely to have fibromyalgia?
|
Middle-aged woman with fatigue, memory, and sleep problems who has an extreme sensitivity to touch
|
|
|
What other conditions are associated with central pain disorders?
|
Regional pain syndromes
Psychiatric disorders -Major depression -OCD -Bipolar -PTSD -GAD -Panic attack |
|
|
What are the properties of central pain?
|
Multifocal
Higher current/lifetime history of pain Other somatic sympoms Sensitive to multiple sensory stimuli |
|
|
What are some of the somatic symptoms involved in central pain?
|
Fatigue
Memory difficulties Sleep disturbances |
|
|
Who gets central pain more commonly, men or women?
|
Women
|
|
|
What can cause episodes of central pain?
|
Stressors
|
|
|
What is the pain phenotype?
|
People who are at highly increased risk to experience chronic pain:
-Female -Family history (chronic pain, mood disturbances) -Early life trauma -Personal history of chronic centraly-mediated symptoms -Lower mechanical pain threshold and descending analgesic activity |
|
|
What is the effect of peripheral pain in someone who is prone to chronic pain?
|
The peripheral pain can move centrally and cause them to have chronic pain in different places of the body
|
|
|
What are some possible triggers of chronic pain?
|
Early life stressors
Peripheral pain syndromes Physical truama War Infections Psychologial stress/distress |
|
|
What are some conditions that display hyperalgesia?
|
Fibromyalgia
TMD IBS Headache OA Idiopathic low back pain RA |
|
|
What are some neurotransmitters that are implicated in fibromyalgia?
|
5-HT
Dopamine Substance P NGF Different tranporters, enzymes that deal with these guys |
|
|
What are the levels of endogenous opioids in people with central pain? What are the implications?
|
Natural opioids are INCREASED!
This makes sense why they don't respond to opioids therapeutically; they're already desensitized |
|
|
What are some central mechanisms by which people are more sensitive to pain?
|
Decreased descending analgesic activity
Insular hyper-reactivity -Increased glutamate, GABA levels Decreased brain size in areas involved in pain processing |
|
|
What are the best pharmacologic therapies for fibromyalgia/central pain?
|
Dual 5-HT and NE reuptake inhibitors:
-Tricyclics -SNRIS, NSRIs Anticonvulsants Tramadol Naltrexone |
|
|
What are some drugs that aren't effective in central pain?
|
Opioids
Corticosteroids NSAIDs BZDs |
|
|
What are effective non-phramacological therapies for chronic pain?
|
Best:
Exercise (aerobic > strength training) CBT Education Modest evidence: Yoga/taichi Hypnotherapy |
|
|
What is the best metaphor for thinking of chronic pain syndromes?
|
There's a pain "volume stat" that's turned up in people with chronic pain.
They're simply more prone (genetically and based on their environment) to experience pain |
|
|
What are the two most treatments for chronic pain?
|
CBT
Exercise |
