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The Nature & Symptoms of Pain
Chapter 11 Dr. Alan H. Teich
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Qualities & Dimensions of Pain
Organic pain vs. Psychogenic pain Acute vs. Chronic Pain
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Qualities & Dimensions of Pain
Chronic pain Benign vs. Malignant Continuous vs. Episodic Types Chronic/recurrent Chronic/intractable/benign Chronic/progressive
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Assessing Pain Self-Report Methods Questionnaires
Behavioral Assessment Physiological Measures
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Personal & Social Experiences and Pain
Learning Emotions
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Physiology of Pain Perception
Noxious stimulation release of algogenic substances at the site e.g., serotonin, histamine, bradykinin Algogenic substances promote immune system activity (inflammation) Inflammation activates free nerve endings signaling pain Free nerve endings: nociceptors
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Physiology of Pain Perception
Afferent peripheral fibers A-delta fibers C fibers
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Pain Without Apparent Physical Basis
Types Neuralgia Causalgia Phantom Limb Pain
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Theories of Pain Specificity Theory Pattern Theory Gate Control Theory
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- - Theories of Pain Gate Control Theory + + + + Brain
Small A-delta & C fibers + + + Substantia Gelatinosa (“The Gate”) - Transmission cells (T cells) - + Large A-beta fibers
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- Theories of Pain + Basbaum & Field’s Descending Analgesic Pathway
Opiates inhibit inhibitory neurons of PAG Theories of Pain Basbaum & Field’s Descending Analgesic Pathway Periaqueductal Grey disinhibition + Interneurons Raphe Nucleus - Spinal Cord Incoming Pain Signals Ascending Anterolateral Pathway to brain
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