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Chronic Pain + Assessment - Coggle Diagram
Chronic Pain + Assessment
Chronic Vs Acute pain
Acute Pain
Single obvious cause, nociceptive pain, protective, proportionate to injury, Treatment of illness relieves pain
Chronic Pain
Can be disease in its own right, neuropathic or nociplastic, not protective, out of proportion of findings, More difficult to treat
Definitions
Allodynia
Pain due to stimulus which does not usually cause pain
Hyperalgesia
Response to stimulus that normally provokes pain
Dysesthesia
Unpleasant abnormal sensation, whether spontaenous or evoked
Hypoesthsia
Decreased sensitivity to stimulation
Paresthesia
Abnormal sensation, spontaneous or evoked
Nociceptive vs Neuropathic Pain
Nociceptive
Normal stimulus by noxious stimuli, and classic pain pathway that consists of transfer from periphery to thalamus to cerebral cortex
Neuropathic Pain
Pain is initiated or caused by primary lesion in central or peripheral nervous system
Location
Central: Post-stroke, multiple sclerosis, spinal cord injury
Peripheral: Diabetic neuropathy, chemotherapy-induced neuropathy, sciatica, post-surgical neuralgia
Mixed: Post-herpetic Neuralgia
Nociplastic Pain
Similar to neuropathic with no lesion to central or peripheral nervous system
Chronic Pain
Pain Lasting Longer than 3 months, pain persisting beyond reasonable amount of time for injury to heal
Peripheral vs Central
Peripheral sensitization: Decreased threshold for activation
Central Sensitization: Results in spontaneous activity, Reduction in threshold, Increased response to stimulation, enlargement of receptive fields
Assessment Tools
DN4
Neuropathic pain questionnairs
LANSS
assessment for neuropathic signs and symptoms
Opioid Risk Tool
Checks for risk of opioid addiction
SOAPP-R
Determine how much monitoring patient on long-term opioid might need
COMM
Current opioid misuse measure
CAGE Questionnaire
AUDIT Questionnaire