ATTRIBUTES OF PAIN How to measure pain
P.Q.R.S.T. P.Q.R.S.T. …..is an acronym that helps you to measure pain by asking fundamental questions
What makes you feel better or worse? P PALLIATIVE OR PROVOKING What makes you feel better or worse?
Can you describe the pain? Q QUALITY What is the pain like? What kind of pain is it? Can you describe the pain?
What is the region involved? Where does it hurt? Does the pain radiate?
Are you able to sleep, to work? SEVERITY How much does it hurt? Can you still work? Are you incapacitated? Are you able to sleep, to work?
T TIME/TEMPORAL When does the pain occur? Is the pain intermittent or constant? What time of the day do you feel the pain?
The different kinds of pain Acute Chronic Malignant Non-malignant Somatic Neuropathic visceral
Acute pain Begins suddenly Sharp in quality Clear defined cause – injury, tissue damage Specific disease
Chronic pain Pain may subside as healing proceeds Continues over time Dull or more severe Lasts for more than 3 months
malignant From cancer radiation therapy chemotherapy
Non-malignant Not life-theatening
somatic …Coming from skin Bone Joint muscle
neuropathic Damage to nerve
visceral Coming from internal organs
Pain examples ANGINA PECTORIS “TIGHT CHEST” TYPICAL MYOCARDIAL INFARCTION PAIN CAUSED BY atherosclerosis (hardening of arteries) People with angina experience pain in the centre of the chest. The chest can feel constricted and tight, but the pain can also be oppressive, as if something is crushing your chest. Pain starts in the centre of the chest behind the breast bone (sternum) or on the left side of the front of the chest. It can spread out to other parts of your body like your arms and stomach. http://www.netdoctor.co.uk/diseases/facts/angina.htm#ixzz2xuJzE13B
Angina pectoris
Heartburn pain Heartburn is a painful burning feeling just below or behind the breastbone. Most of the time it comes from the esophagus. The pain often rises in your chest from your stomach and may spread to your neck or throat. http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm
HEARTBURN PAIN REGION
Heartburn or heart attack? It usually occurs after eating or while lying down or bending. It can be brief or continue for a few hours. You notice a burning sensation in your chest that may start in your upper abdomen and radiate all the way to your neck. Stomach acid that moves up into the esophagus
QUIZ What is HYPERALGESIA? An increased sensitivity to pain
paresthesia An abnormal sensation (not unpleasant) Part numbed or insensitive “pins and needles” sensation
myalgia Muscle pain
Pain in a limb that has been amputated… Phantom pain
Arthralgia and neuralgia Joints and nerve pain
The most common site of joint pain? The knee
analgesia Without pain
C.I.P.A. Congenital Insensitivity to Pain with Anhidrosis A rare disorder where there is total absence of pain and sweating No feelings of pain even with damage or injury Ability to keep tollerate freezing temperatures
Pain is measured… 0-10 0 - no pain 10 – worst pain
Narcotics Used to induce stupor
Poena - pain From Latin meaning penalty
Pain threshold Women have a higher tollerance of pain Delivery Labour Menstrual pain- Dysmenorrhea