Week 7 Pain
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Questions and Answers

Which type of neurons carry information from the periphery to the spinal cord?

  • Aβ fibres
  • 1st order neurons (correct)
  • 3rd order neurons
  • 2nd order neurons

    • What is the function of Aβ fibres?

  • Relay information from thalamus to cerebral cortex
  • Carry information from nociceptors responsible for sharp and localized pain
  • Carry information from nociceptors responsible for dull and diffuse pain
  • Carry non-painful information from mechanoreceptors and thermoreceptors (correct)

    • Which type of fibres carry information from nociceptors responsible for sharp and localized pain?

  • Aβ fibres
  • 3rd order neurons
  • Aδ fibres (correct)
  • C fibres

    • What is the function of C fibres?

    <p>Carry information from nociceptors responsible for dull and diffuse pain</p> Signup and view all the answers

    Where do signals from nociceptors cross over to the contralateral side of the spinal cord?

    <p>Spinothalamic tract</p> Signup and view all the answers

    What is the function of second-order neurons?

    <p>Synapse with first-order neurons in the spinal cord</p> Signup and view all the answers

    What is the function of third-order neurons?

    <p>Relay information from thalamus to cerebral cortex</p> Signup and view all the answers

    What is the purpose of the change in ion channels mentioned in the text?

    <p>To limit the use of an injured part until it is fully repaired</p> Signup and view all the answers

    What is peripheral sensitization?

    <p>Sensitization of nociceptive neurons in the periphery</p> Signup and view all the answers

    What is the difference between peripheral and central sensitization?

    <p>Peripheral sensitization contributes to pain from acute local injury, while central sensitization contributes to pain in chronic widespread pain conditions</p> Signup and view all the answers

    What is central sensitization?

    <p>Sensitization of neurons within the CNS</p> Signup and view all the answers

    What are some mechanisms that may explain central sensitization?

    <p>Increased membrane excitability, synaptic facilitation, and decreased activity of inhibitory neurons</p> Signup and view all the answers

    What is wind-up or temporal summation?

    <p>The consequence of cumulation of action potentials</p> Signup and view all the answers

    What is hyperalgesia?

    <p>Where mildly noxious stimuli are perceived as painful</p> Signup and view all the answers

    What is allodynia?

    <p>Where pain is due to a stimulus that does not normally provoke pain</p> Signup and view all the answers

    How can we measure wind-up or temporal summation?

    <p>By examining responses to graded stimuli</p> Signup and view all the answers

    What are the main categories of pain?

    <p>Nociceptive, neuropathic, and nociplastic</p> Signup and view all the answers

    What is the primary goal of physiotherapy for patients with pain?

    <p>Pain management</p> Signup and view all the answers

    What are nociceptors?

    <p>Receptors that respond to strong stimuli that are harmful or potentially harmful to tissues</p> Signup and view all the answers

    What is peripheral sensitization?

    <p>Increased responsiveness and reduced threshold of nociceptors</p> Signup and view all the answers

    What is central sensitization?

    <p>Increased responsiveness and reduced threshold of neurons in the central nervous system</p> Signup and view all the answers

    What are the two types of stimuli that thermoreceptors respond to?

    <p>Heat or cold</p> Signup and view all the answers

    What is the economic burden of pain?

    <p>The financial cost of pain on society</p> Signup and view all the answers

    What is nociception?

    <p>The process of sensory neurons detecting strong stimuli in the tissues</p> Signup and view all the answers

    What is the 'spinal gate' mechanism?

    <p>All of the above</p> Signup and view all the answers

    What is pain modulation?

    <p>The process by which events occur at multiple levels to change the perception of pain</p> Signup and view all the answers

    What are the two types of neurotransmitters involved in pain perception?

    <p>Excitatory and inhibitory</p> Signup and view all the answers

    What is the difference between nociception and pain?

    <p>Nociception is the process of sensory neurons detecting strong stimuli in the tissues, while pain is an aversive sensory and emotional experience typically caused by actual or potential tissue injury</p> Signup and view all the answers

    What is the role of descending pain pathways?

    <p>To modulate pain by inhibiting or facilitating input arriving at the spinal cord</p> Signup and view all the answers

    What is the 'spinal gate' mechanism?

    <p>All of the above</p> Signup and view all the answers

    Which type of pain is a normal and time-limited response to inflammation or tissue damage?

    <p>Acute pain</p> Signup and view all the answers

    What is referred pain?

    <p>Pain that is perceived at a site different from its point of origin but innervated by the same spinal segment</p> Signup and view all the answers

    What is the difference between acute pain and chronic pain?

    <p>Acute pain is a normal and time-limited response to tissue damage, while chronic pain persists beyond the expected timeframe of healing</p> Signup and view all the answers

    What is nociplastic pain?

    <p>Pain caused by abnormal pain processing in the nervous system</p> Signup and view all the answers

    What is the purpose of mechanism-based classification of pain?

    <p>To identify the factors that contribute to the development, maintenance or enhancement of pain</p> Signup and view all the answers

    What is chronic pain?

    <p>Pain that lasts more than 3 months</p> Signup and view all the answers

    What is neuropathic pain?

    <p>Pain caused by abnormal pain processing in the nervous system</p> Signup and view all the answers

    What are the three main categories identified in the National strategic action plan for pain management 2019?

    <p>Nociplastic, nociceptive, neuropathic</p> Signup and view all the answers

    What is the primary cause of nociceptive pain?

    <p>Injury, inflammation, or mechanical irritants</p> Signup and view all the answers

    What is the primary cause of nociplastic pain?

    <p>Increased sensitization within the nervous system</p> Signup and view all the answers

    What is the primary cause of neuropathic pain?

    <p>Direct injury to the nerve</p> Signup and view all the answers

    How can we recognize nociceptive pain by its quality?

    <p>Often intermittent, sharp and localized to area of injury/damage</p> Signup and view all the answers

    How can we recognize nociplastic pain by its behavior?

    <p>Pain is disproportionate to the nature &amp; extent of injury/pathology</p> Signup and view all the answers

    What are some examples of conditions that may cause neuropathic pain?

    <p>Carpal tunnel syndrome, diabetes</p> Signup and view all the answers

    Which of the following is a symptom of diabetic sensory peripheral neuropathy?

    <p>Numbness</p> Signup and view all the answers

    What is the cause of post herpetic neuralgia?

    <p>Reactivated varicella zoster virus</p> Signup and view all the answers

    What is the distribution of nerve damage in diabetic sensory peripheral neuropathy?

    <p>First glove and stocking distribution</p> Signup and view all the answers

    What is the main symptom of post herpetic neuralgia?

    <p>Severe, burning pain</p> Signup and view all the answers

    What is the main characteristic of complex regional pain syndrome?

    <p>Lesion of the somatosensory system</p> Signup and view all the answers

    What is the previous name for complex regional pain syndrome?

    <p>Reflex sympathetic dystrophy</p> Signup and view all the answers

    What is the cause of nerve damage in post herpetic neuralgia?

    <p>Reactivated varicella zoster virus</p> Signup and view all the answers

    What is the main symptom of diabetic sensory peripheral neuropathy?

    <p>Numbness</p> Signup and view all the answers

    What is the main characteristic of nerve pain in post herpetic neuralgia?

    <p>Localized to one area</p> Signup and view all the answers

    What are some examples of conditions that can cause neuropathic pain?

    <p>Diabetic peripheral neuropathy</p> Signup and view all the answers

    What are some ways to recognize neuropathic pain?

    <p>By its behavior</p> Signup and view all the answers

    What is the fear avoidance model?

    <p>A model of psychosocial factors</p> Signup and view all the answers

    What is fibromyalgia?

    <p>A chronic pain condition</p> Signup and view all the answers

    What is the distribution of symptoms in diabetic peripheral neuropathy?

    <p>Symmetrical polyneuropathy</p> Signup and view all the answers

    What are some ways that psychosocial factors can influence pain?

    <p>By changing thoughts, beliefs, and emotions</p> Signup and view all the answers

    What are some examples of conditions that can cause nociplastic pain?

    <p>Fibromyalgia</p> Signup and view all the answers

    Study Notes

    Neurons and Pain Pathways

    • Afferent neurons transmit information from peripheral tissues to the spinal cord.
    • Aβ fibres are responsible for carrying non-painful stimuli such as touch and vibration, contributing to the sensation of pressure and proprioception.
    • Sharp and localized pain is carried by Aδ fibres, which transmit signals rapidly due to their myelination.
    • C fibres transmit dull, aching pain and are unmyelinated; they convey slower pain responses from tissues.
    • Signals from nociceptors crossover to the contralateral side of the spinal cord at the level of the dorsal horn.

    Neuron Functions

    • Second-order neurons relay pain signals from the spinal cord to the brain, contributing to the pain perception process.
    • Third-order neurons further transmit signals from the thalamus to the sensory cortex, allowing for pain localization and interpretation.
    • Changes in ion channels can alter neuronal excitability, affecting pain thresholds and sensitivity.

    Sensitization Processes

    • Peripheral sensitization refers to an increased sensitivity of nociceptors to stimuli caused by inflammation or injury.
    • Central sensitization is a heightened response of neurons in the central nervous system following stimuli.
    • Peripheral sensitization impacts nociceptors, while central sensitization affects central pathways.
    • Mechanisms explaining central sensitization include wind-up, altered neurotransmitter release, and receptor changes.
    • Wind-up or temporal summation occurs when repeated stimuli lead to progressively stronger pain sensations.

    Pain Types and Characteristics

    • Hyperalgesia is an exaggerated response to a painful stimulus.
    • Allodynia is pain due to a stimulus that normally does not provoke pain.
    • Wind-up or temporal summation can be assessed through quantitative sensory testing.
    • Pain is categorized primarily into nociceptive, neuropathic, and nociplastic.
    • The main goal of physiotherapy for patients with pain is to reduce pain and improve functional outcomes.

    Nociception and Pain Modulation

    • Nociceptors are specialized sensory receptors that respond to potentially damaging stimuli.
    • Nociception refers to the sensory process that encodes harmful stimuli, while pain is the subjective experience resulting from nociception.
    • The 'spinal gate' mechanism filters pain signals in the spinal cord, influencing pain perception.
    • Pain modulation involves both descending pathways from the brain that can enhance or inhibit pain signals.
    • Two main types of neurotransmitters involved in pain perception are excitatory (e.g., glutamate) and inhibitory (e.g., GABA).

    Pain Classification

    • Acute pain is a normal, temporary response to inflammation or tissue injury; chronic pain persists beyond the expected healing time.
    • Nociplastic pain arises from altered pain processing without clear nociceptive or neuropathic causes.
    • Chronic pain has a duration exceeding three months and impacts daily functioning.
    • Neuropathic pain results from nerve damage or dysfunction.

    Recognizing and Managing Pain

    • Nociceptive pain is characterized by sharp, localized sensations often resulting from injury.
    • Nociplastic pain exhibits variable behaviors, often relating to psychological factors.
    • Conditions like diabetic neuropathy, post-herpetic neuralgia, and fibromyalgia can cause neuropathic pain.
    • Symptoms of diabetic sensory peripheral neuropathy include numbness, tingling, and pain, predominantly affecting the legs and feet.

    Specific Conditions

    • Diabetic sensory peripheral neuropathy damage is often bilateral and symmetric, primarily affecting distal nerve fibers.
    • The main symptom of post-herpetic neuralgia is persistent pain following a shingles infection.
    • Complex regional pain syndrome was previously known as reflex sympathetic dystrophy, marked by chronic pain and sympathetic nervous system dysregulation.
    • Neuropathic pain can be associated with conditions like multiple sclerosis, phantom limb pain, and shingles.

    Psychological Aspects

    • The fear avoidance model describes how fear of pain can lead to avoidance of activities, perpetuating chronic pain cycles.
    • Psychosocial factors, such as anxiety and depression, can significantly influence pain perception and management outcomes.
    • Recognizing nociplastic pain involves assessing the patient's pain history, psychological state, and symptom patterns.

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    Description

    Test your knowledge on the brain's role in pain perception and localization with Davidson's 23rd Ed Building Blocks of Pain quiz. Discover the multiple brain structures responsible for the emotional and attentional aspects of pain and memory formation.

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