1. ATTRIBUTES OF PAIN
How to measure pain

2. P.Q.R.S.T.
P.Q.R.S.T.
…..is an acronym that helps you to measure pain by asking fundamental questions

3. What makes you feel better or worse?P
PALLIATIVE OR PROVOKING
What makes you feel better or worse?

4. Can you describe the pain?Q
QUALITY
What is the pain like?
What kind of pain is it?
Can you describe the pain?

5. What is the region involved?
Where does it hurt?
Does the pain radiate?

6. 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?

7. T TIME/TEMPORAL When does the pain occur?
Is the pain intermittent or constant?
What time of the day do you feel the pain?

8. The different kinds of pain
Acute
Chronic
Malignant
Non-malignant
Somatic
Neuropathic
visceral

9. Acute pain Begins suddenly Sharp in quality
Clear defined cause – injury, tissue damage
Specific disease

10. Chronic pain Pain may subside as healing proceeds Continues over time
Dull or more severe
Lasts for more than 3 months

11. malignant
From cancer
radiation therapy
chemotherapy

12. Non-malignant
Not life-theatening

13. somatic
…Coming from
skin
Bone
Joint
muscle

14. neuropathic
Damage to nerve

15. visceral
Coming from internal organs

16. 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.  

17. Angina pectoris

18. 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.

19. HEARTBURN PAIN REGION

20. 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

21. QUIZ
What is HYPERALGESIA?
An increased sensitivity to pain

22. paresthesia An abnormal sensation (not unpleasant)
Part numbed or insensitive
“pins and needles” sensation

23. myalgia
Muscle pain

24. Pain in a limb that has been amputated…
Phantom pain

25. Arthralgia and neuralgia
Joints and nerve pain

26. The most common site of joint pain?
The knee

27. analgesia
Without pain

28. 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

29. Pain is measured…
0-10
0 - no pain
10 – worst pain

30. Narcotics
Used to induce stupor

31. Poena - pain
From Latin meaning penalty

32. Pain threshold Women have a higher tollerance of pain Delivery Labour
Menstrual pain- Dysmenorrhea