Pain

Question 1

Define pain.

Answer 1

Pain –an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

Acute Pain

• Well-defined pain onset
• Associated with sympathetic nervous system arousal
• Serves a biological purpose
• Directs attention to injury, irritation, or disease
• Signals the need for immobilization and protection of a body part
• Responds to medication and treatment of underlying cause of pain

Chronic Pain

• May begin as acute pain
• Increased sympathetic nervous system activity does not continue
• Does not appear to serve a biological purpose
• Not amenable to routine methods of pain control

Question 2

Identify areas for evaluation, assessment, and observation that can be used to measure pain.

Answer 2

Evaluation

• Baseline Measurements:
• Decreased Occupational Performance
• Pain Perception
• Pain Interference
• Occupational Role Disruption
• Decreased Quality of Life

Pain is a complex phenomenon involving:

• Psychological Arousal
• Sensations of Noxious Stimulation, Tissue Damage, or Irritation
• Behavioral Avoidance
• Complaints of Subjective Distress
• Social Environment

Self-Report Measures

• Pain location
• Frequency
• Duration
• Intensity
• Onset
• Exacerbating and Relieving Factors
• Past and Present Pain Treatments
• Affect
• Occupational Performance

Self-Report Measurement Tools:

• Verbal Rating Scale (VRS)
• 0-10 Numeric Pain Intensity Scale
• Visual Analog Scale (VAS)
• Self-report tools are the most reliable in measuring pain

Pain Behaviors:

• Guarded Movement
• Bracing
• Posturing
• Limping
• Rubbing
• Facial Grimacing

Pain Behaviors:

• University of Alabama Pain Behavior Scale
• Document pain behaviors:
  
  • -Before
  • -During
  • -After

Intervention

• Identifies situational and learned behavior
• Daily Activity Diaries
• Assessment Technique
• Outcome Measure
• Highly reliable and valid
• Hourly entries on time spent in:
  
  • -Sitting
  • -Standing
  • -Reclining
  • -Productive Activities

Brief Pain Inventory (BPI)

• Measures pain interference
• Ordinal Scale
• Reliable and Valid Instrument
• Brief Pain Inventory (BPI)
• How much has pain interfered with:
• General activity•
• Mood
• Mobility
• Work
• Interpersonal relationships
• Sleep
• Enjoyment of life
• Self-care
• Recreation

Question 3

List and briefly describe 11 interventions that can be used for pain.

Answer 3

Intervention

1. Medication
2. Activity Tolerance
3. Body Mechanics and Posture Training
4. ECT’s, Pacing, and Joint Protection
5. Splinting
6. Adaptive Equipment
7. Relaxation
8. Biofeedback
9. Distraction
10. Therapeutic Modalities
11. Transcutaneous Electrical Nerve Stimulation (TENS)