PAIN Chapter 31
What Is Pain?
• ➢Unpleasant sensory/emotional experience
• ➢Can have destructive effects
• ➢Can warn of potential injury
• ➢A multidimensional experience
What Is Pain?
▪ ▪Pain is most common reason people seek medical care in USA
▪ Pain
▪ experience can signifcantly interfere w/ person’s quality of life, afectng nearly every
aspect of life.
▪ severe back pain can afect a pt’s job performance, engagement in social actvites, sexual intmacy,
sleep & rest, ability to exercise, & ability to perform ADLs
▪ These factors can afect intensity of pt’s pain, as well as pt’s response to pain.
▪ ▪ Pain can cause sleep loss, irritability, cognitve impairment, functonal impairment, &
immobility, & it can be destructve to the pt & family.
Classification of Pain
By origin:
Superficial
Visceral
Somatic
Radiating/referred
Phantom
Psychogenic
Superficial
▪ arises in skin or subcutaneous tssue
▪ If you have ever touched a hot object or received a paper cut, you have experienced superfcial pain.
▪ Although injury is superfcial, it may cause signifcant short-term pain.
Visceral
• is caused by stmulaton of deep internal pain receptors
• It is most often experienced in abdominal cavity, cranium, or thorax.
• Not well localized & can be described as tght, pressure, or crampy pain.
, • Descripton of quality & extent of pain often serves as a strong clue to the cause.
Menstrual cramps, labor pain, GI infectons, bowel disorders, & organ cancers all produce visceral
pain.
Somatic
▪ pain originates in ligaments, tendons, nerves, blood vessels, & bones.
▪ Deep somatc pain is more localized & can be described as achy or tender.
▪ A fracture or sprain, arthrits, & bone cancer can cause deep somatc pain.
▪
–Radiating
▪ pain starts at the origin but extends to other locatons.
▪ For instance, the pain of a severe sore throat may extend to ears & head.
▪ Or pain of an episode of gastroesophageal reflux (“heartburn”) may radiate outward from the
sternum to involve the entre upper thorax.
Phantom
pain is perceived to originate from an area that has been surgically removed.
Pts with amputated limbs may stll perceive that the limb exists & experience burning, itching, &
deep pain in that area
Psychogenic
▪ pain is believed to arise from the mind.
▪ Pt perceives the pain despite the fact that no physical cause can be identfed.
▪ can be just as severe as pain from a physical cause
Referred
• pain occurs in an area that is distant from the original site.
• For example, the pain from a heart attack may be experienced down the left arm, through the back,
or into the jaw
By cause
Nociceptve
Neuropathic
•
By quality
By duraton
▪ Acute
▪ Chronic
▪ Intractable
• ➢Nociceptive
pain occurs when pain receptors (nociceptors) respond to stmuli that are potentally damaging, as a
result of noxious thermal, chemical, or mechanical stmuli.
may occur as a result of trauma, surgery, or inflammaton
➢Neuropathic
is a complex & often chronic pain that arises when injury to one or more nerves results in repeated
transmission of pain signals even in absence of painful stmuli
What Is Pain?
• ➢Unpleasant sensory/emotional experience
• ➢Can have destructive effects
• ➢Can warn of potential injury
• ➢A multidimensional experience
What Is Pain?
▪ ▪Pain is most common reason people seek medical care in USA
▪ Pain
▪ experience can signifcantly interfere w/ person’s quality of life, afectng nearly every
aspect of life.
▪ severe back pain can afect a pt’s job performance, engagement in social actvites, sexual intmacy,
sleep & rest, ability to exercise, & ability to perform ADLs
▪ These factors can afect intensity of pt’s pain, as well as pt’s response to pain.
▪ ▪ Pain can cause sleep loss, irritability, cognitve impairment, functonal impairment, &
immobility, & it can be destructve to the pt & family.
Classification of Pain
By origin:
Superficial
Visceral
Somatic
Radiating/referred
Phantom
Psychogenic
Superficial
▪ arises in skin or subcutaneous tssue
▪ If you have ever touched a hot object or received a paper cut, you have experienced superfcial pain.
▪ Although injury is superfcial, it may cause signifcant short-term pain.
Visceral
• is caused by stmulaton of deep internal pain receptors
• It is most often experienced in abdominal cavity, cranium, or thorax.
• Not well localized & can be described as tght, pressure, or crampy pain.
, • Descripton of quality & extent of pain often serves as a strong clue to the cause.
Menstrual cramps, labor pain, GI infectons, bowel disorders, & organ cancers all produce visceral
pain.
Somatic
▪ pain originates in ligaments, tendons, nerves, blood vessels, & bones.
▪ Deep somatc pain is more localized & can be described as achy or tender.
▪ A fracture or sprain, arthrits, & bone cancer can cause deep somatc pain.
▪
–Radiating
▪ pain starts at the origin but extends to other locatons.
▪ For instance, the pain of a severe sore throat may extend to ears & head.
▪ Or pain of an episode of gastroesophageal reflux (“heartburn”) may radiate outward from the
sternum to involve the entre upper thorax.
Phantom
pain is perceived to originate from an area that has been surgically removed.
Pts with amputated limbs may stll perceive that the limb exists & experience burning, itching, &
deep pain in that area
Psychogenic
▪ pain is believed to arise from the mind.
▪ Pt perceives the pain despite the fact that no physical cause can be identfed.
▪ can be just as severe as pain from a physical cause
Referred
• pain occurs in an area that is distant from the original site.
• For example, the pain from a heart attack may be experienced down the left arm, through the back,
or into the jaw
By cause
Nociceptve
Neuropathic
•
By quality
By duraton
▪ Acute
▪ Chronic
▪ Intractable
• ➢Nociceptive
pain occurs when pain receptors (nociceptors) respond to stmuli that are potentally damaging, as a
result of noxious thermal, chemical, or mechanical stmuli.
may occur as a result of trauma, surgery, or inflammaton
➢Neuropathic
is a complex & often chronic pain that arises when injury to one or more nerves results in repeated
transmission of pain signals even in absence of painful stmuli
