Understanding and Managing Pain

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Presentation transcript:

Understanding and Managing Pain

Insensitivity to pain = many injuries

Somatosensory System Moves info. From body to brain

Neurons Afferent (sensory) neurons Interneurons - Connect sensory neurons to motor neurons Efferent (motor) neurons

Somatosensory cortex

Brain Scans PET fMRI

Pain

Definition of pain Sensation + emotional reaction to sensation

Types of pain Acute Chronic Occurs when injured - cut, burn, childbirth, surgery Adaptive Warns of further injury Chronic Lasts months or years Not adaptive No biological benefit Reinforced by environmental factors Sympathy It is still real pain

The experience of pain Anzio beachhead Carrying severed arm People not realizing they were shot

Expression of pain Cultural background & social context E.g. Childbirth Rites of passage

Theories of pain

Specificity theory of pain Pain = amount of tissue damaged Pain largely uninfluenced by psychological forces Problems No specific skin receptors devoted to relaying pain Phantom limb pain Injury without pain E.g. in war

Gate control theory of pain Sensory input is not the only factor in pain perception Changes in the spinal column and brain control the flow of neural impulses Parts of spinal column can either increase (open the gate) or decrease (close the gate)

Measurement of pain 1. Self-report 2. Behavioral assessments Rating scales (e.g. 0-10) MMPI 2. Behavioral assessments Observing a patient’s behavior 3. Physiological measures Electromyography (EMG) Muscle tension Not a very good method (Poor validity)

Phantom limb pain Common following amputation Decreases with time

Managing pain with medicine Self-paced administration of narcotics E.g. morphine pump Limits are programmed in Avoids undermedication Patients use less medication Higher satisfaction

Managing pain with behavior Relaxation training Reduces Headaches Rheumatoid arthritis Low back pain Behavior modification Based on operant conditioning Positive reinforcers for pain - e.g. sympathy Increase pain Reinforcing desirable (non pain) behavior Reduces pain

Managing pain with behavior Cognitive behavioral therapy (CBT) Changing your thinking patterns E.g. “Reframing” - “Pain is weakness leaving the body” - Used in the military