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What is pain? According to the International Association for the Society of Pain, Pain is: “An...

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What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. http: /www.iasppain.orgContentNavigationMenuGeneralResourceLi nks /PainDefinitions/default.htm
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Page 1: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

What is pain?

According to the International Association for the Society of Pain,

Pain is:

“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or

described in terms of such damage”.

http:/www.iasppain.orgContentNavigationMenuGeneralResourceLinks/PainDefinitions/default.htm

Page 2: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

• “Pain can be due to a wide variety of diseases, disorders and conditions that range from a mild injury to a debilitating disease”.

http://www.localhealth.com/article/pain

Aetiology: What causes pain?

Page 3: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Aetiology

Page 4: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Acute & Chronic Pain“The terms acute and chronic refer exclusively to the time course of the pain,

irrespective of aetiology” (Craft, Gordon, and Tiziani, 2011, p.144).

Acute Pain:

• Acute pain refers to any pain that lasts less than 3 months.

• Usually has a predicable ending (healing).

• Examples: Aching muscles after exercise, cut to the finger, broken bone.

Page 5: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Chronic Pain:

• Chronic Pain is a “persistent or recurring pain that continues for more than 3 months” (Bryant & Knights, 2011, p.281).

• Usually prolonged, recurring or persisting over a long period time.

• Examples include: arthritis and back pain

Page 6: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Another way to categorise pain is to refer to the pathophysiology of pain:

• Nociceptive• Neuropathic• Psychogenic

Page 7: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Nociceptive:

• Most common type of pain. • Typically described as sharp and well localised.• Caused by irritation of the peripheral sensory

nerves.

(Glouke, 2003, p. 444)

Page 8: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Nociceptive:

• External:• Most common, pain usually involves trauma to the skin but may

extend to the underlying tissues. • Usually lasts from a few seconds to a few days.

• Internal• Less common and usually more severe. It has numerous causes, eg

severe trauma due to bone fractures, surgery or childbirth.• Virtually a symptom of all diseases at some point during disease

progression.• Usually lasts few days to weeks.

Page 9: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Neuropathic Pain

• Injury or disease of the central nervous system rather than the peripheral tissue.

• Usually lasts between a few months to many years.

• Difficult to treat due to the lack of knowledge of the underlying cause.

• May occur in the presence of a neurological deficit

• May be unaccompanied by ongoing tissue damage.

• May occur in an area of sensory loss.• May be burning, shooting or pins and needles

(not sharp like nociceptive).

Page 10: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Psychogenic Pain

• Severe and persistent pain but for which there appears to be no underlying pathology.

• Pain experienced (Headaches, abdominal pain, back pain) is indistinguishable from that experienced by people with identifiable injuries or diseases.

• This kind of pain can be very frustrating to sufferers and can interfere with their ability to function normally.

Page 11: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Clinical Manifestations of Pain“No two people are likely to experience the same level of pain for a given painful stimulus” (Craft et al., 2011, p.150).

Pain Tolerance:“Maximum amount of painful stimuli that a person is willing to withstand without seeking avoidance of the pain or relief” (Berman et al., 2010, p.1249).

What affects Pain Tolerance?Fatigue, anger, boredom, apprehension, sleep deprivation. Alcohol consumption, medication, hypnosis, warmth, distracting activities and strong beliefs or faiths.

Page 12: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Pain tolerance is influenced by a number of factors including;

• Age• Cultural perceptions • Expectations• Gender• Physical and mental health

Page 13: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Age:• Different reaction to pain• Understanding of pain

Gender:• “Females display greater sensitivity to pain than males do.

There are differences in the way women cope with pain, report pain and respond to pain” (Crisp & Taylor, 2009, p.1096).

Physical & Mental Health• Physical mobility• Depression, difficulty coping, fatigue.

Page 14: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Cultural Variations:Cultures vary in the meaning of pain, how if it expressed and how it is treated:• Meaning • Expression • Treatment

Page 15: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Pain Threshold• Pain Threshold is the “lowest intensity at which a stimulus is

perceived as pain and may be influenced by genetics” (Craft et al., 2011 p.150).

Page 16: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Location:

• It is important record a patients pain location to be able to monitor any changes.

• Pain can feel like it is coming from one part of the body but in fact it is another, this type of pain is called referred pain.

Page 17: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Signs and Symptoms:• “Pain elicits a stress response in the human body, triggering the

sympathetic nervous system, resulting in physiological responses” (Weber 2010 p. 93)

When someone is in pain they may:• Scream, cry, jump around, swear, change facial expressions.

Patient may describe pain as:• Sharp, stabbing, Dull, achy, burning, pins & needles sensation.

Patients may experience an increase in:• Temperature, Blood pressure, Ventilation, Nausea vomiting, Sweating,

Anxiety, fear, fatigue, insomnia, suicidal thoughts.

Page 18: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

Case Study Name: DavidAge: 30Gender: MaleSummary: Sustained an injury to his calcanium in his left foot after falling from a height of 3 metres at work.

Vital signs:• B/P: 120/70• Temperature: 36.6• Pulse: 120• Respirations: 22• Sao2: 100%

Page 19: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

What are the possible aetiologies of David’s pain?

• Injury to left heel bone caused by injury at work where he fell 3 metres.• Already had previous injury in his ankle from playing football a year ago

• (Not sure what else to write here…..)

Page 20: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

• What are the physiological manifestations of the signs and symptoms David s experiencing?

• Swelling• Numbness• Tenderness• Pain• Decreased mobility• Tachycardia• Shock?

(If you can think of any more please add)

Page 21: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

• Questions for quiz:• What is the difference between Chronic and Acute pain?• What are the 3 types of pain?• List 3 factors that influence pain

Page 22: What is pain? According to the International Association for the Society of Pain, Pain is: “An unpleasant sensory and emotional experience associated with.

ReferencesBerman, A., Snyders, S., Kozier, B., Erb, G., Levert-Jones, T., Dwyer, T.,… Stanley, D. (2010). Kozier & Erb’s fundamentals of nursing. (1st Australian ed.). Sydney: Pearson & Prentice Hall.

Bryant, B., & Knights, K. (2011) Pharmacology for Health Professionals (3rd ed.). Chatswood NSW: Elsevier Mosby.

Crisp, J., & Taylor, C. (2009) Potter & Perry’s fundamentals of nursing (3rd ed.). Chatswood, NSW: Elsevier Mosby.

Craft, J., Gordon, C., & Tiziani, A. (2011) Understanding pathophysiology. Chatswood NSW: Elsevier Mosby.Glouke, R. C., (2003) The Management of persistent pain. Medical Journal of Australia, 178(9), 444-447.

Loeser, D. (2011) IASP Taxonomy. Retrieved from http://www.iasp-pain.org/Content/NavigationMenu/GeneralResourceLinks/PainDefinitions/default.htm

Weber, J. R., (2010) Nurses’ handbook of health assessment. ( 7th ed.). Sydney: Woters Kluwer Health / Lippincott Williams & Wilkins.

Williams, R. (2011) Pain. Retrieved from http://www.localhealth.com/article/pain


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