PAIN MANAGEMENT

Pain
 A noxious stimulation of actual or
threatened / potential tissue damage

Categories of Pain according to Origin
 Cutaneous
o Skin
 Deep Somatic
o Tendons, ligaments
o Bones
o Blood Vessels
 Visceral Pain
o Organs of the body

Categories of Pain based on Cause
 Acute
o Due to trauma or surgery
o Persists for less than six (6)
months
 Chronic Malignant Pain
o Related to cancer
o On and off
o Persists for more than six (6)
months
 Chronic Non-malignant Pain
o Persists for more than six (6)
months

Categories of Pain according to Where It

o Felt on the source and is
extending to nearby tissues
 Referred Pain
o Felt on other parts detached
from the source
o Example:
o Pain on a lacerated liver may
be felt on the right shoulder
and not on the right upper
quadrant
 Intractable Pain
o Highly resistant to pain-relief
methods
 Phantom Pain
o Pain that is felt on a
MISSING BODY PART or a
PART
THAT
IS
PARALYZED by SPINAL
CORD INJURY.

Pain Threshold
 Amount of pain stimulation that is
required in order to feel pain

Pain Tolerance
 Maximum amount of pain and
duration that a person is willing to
endure

Gate Control Theory
Concept!
 This is the most widely used theory
in pain management

Is Experienced
 Radiating Pain

Concepts!

The R.A Gapuz Review Center Inc. makes no representations about the accuracy, authenticity, and reliability of this compilation. It declaims any and all
responsibility or liability for plagiarism, copyright infringement and violation of related laws in connection with the contents of the materials. It had no
participation and compilation thereof such being sole responsibility of the reviewer concerned. This disclaimer serves as a notice to the public that R. A.
Gapuz Review Center Inc. shall not be liable for any complaints, actions or suits in connection with the contents of the materials of this compilation.

1

shall not be liable for any complaints.A Gapuz Review Center Inc. copyright infringement and violation of related laws in connection with the contents of the materials.  This gate is called the SUBSTANCIA GELATINOSA  A series of nerves pass through this gate  Small diameter nerve fibers pass through the substancia gelatinosa o Pain signals are carried to the spinal cord by the small diameter nerve fibers  Large diameter nerve fibers also pass through the substancia gelatinosa o Large diameter nerve fibers close the gate – prevents the transmission of impulses through the spinal cord o Therefore. and reliability of this compilation. 2 . Pain Management Strategies Pharmacologic Methods  Narcotics  NSAIDs  Adjuvants or Co-analgesics Non-Pharmacologic Methods  Physical Interventions  Cognitive / Behavioral Interventions Non-Pharmacologic Physical Interventions 1. there is vasoconstriction  This is an inherent defense mechanism from burning of tissues  Cold Application o Maximum vasoconstriction is reached when skin reaches 15°C o If there is further drom in temperature. THE GATE IS CLOSED  Pain management operates on the principle of how to stimulate the Large Diameter Nerve Fibers to close the gate. Gapuz Review Center Inc. It declaims any and all responsibility or liability for plagiarism. vasodilation is produced  If heat is applied for more than 20 minutes. makes no representations about the accuracy. actions or suits in connection with the contents of the materials of this compilation. At the dorsal horn of the spinal cord is a gate. when LARGE DIAMETER NERVE FIBERS ARE STIMULATED. there is vasodilation (skin becomes reddish) o This is the inherent defense mechanism from being frozen The R. Cutaneous Stimulation  Massage o Effleurage o Soft massage o Gentle stroking  Petrissage o Hard massage o Large and quick pinches o Also done by striking  Application of Counter-Irritant o Bengay o Menthol o Omega Pain Killer o Flax Seeds o Poultices  Heat and Cold Application o Nursing Alert! o Rebound Phenomenon  When you apply heat (usually done for 20 minutes). It had no participation and compilation thereof such being sole responsibility of the reviewer concerned. This disclaimer serves as a notice to the public that R. A. authenticity.

makes no representations about the accuracy. shall not be liable for any complaints. Accupressure o Pressure on certain points of the body o Stimulates release of endorphins. A.Transcutaneous Electrical Nerve  Relieves pain because of its intent and not because of physical or chemical properties Cognitive or Behavioral NonPharmacologic Interventions  Purpose: o To alter pain perception o To alter pain behavior o To provide client with a greater sense of control over the pain Specific Interventions 1.Rhythmic Singing and Tapping  Key Concept! o Faster beat music is more preferable 3 The R. actions or suits in connection with the contents of the materials of this compilation.Administration of a Placebo 3. copyright infringement and violation of related laws in connection with the contents of the materials. It declaims any and all responsibility or liability for plagiarism. which have natural analgesic effects o This started in Ancient China  Accupuncture o Insertion of long slender needles on certain chemical pathways o Origin is also Ancient china  Contralateral Stimulation o Example: Injury on left side and massage is done on the right side o Useful when patient cannot be accessed:  For patients in a cast  For patients with burns  For patients with phantom pain 2.A Gapuz Review Center Inc. It had no participation and compilation thereof such being sole responsibility of the reviewer concerned. Gapuz Review Center Inc.Massage and Slow Rhythmic Breathing  Composed of electrodes  Operated by battery  Electrodes are applied on painful site or over the spinal cord 4. Immobilization  Application of splints 3.Distraction  Purpose is to divert attention from pain  Slow Rhythmic Breathing o Stare at a certain object o Take deep breath slowly o Release or exhale slowly o Concentrate on breathing o Picture a peaceful scene o Establish a rhythmic pattern Stimulation 2. and reliability of this compilation. . authenticity. This disclaimer serves as a notice to the public that R.

This disclaimer serves as a notice to the public that R.A Gapuz Review Center Inc. .Hypnosis  The success of hypnosis depends on the ability of the patient to concentrate and the capacity of the hypnotist to suggest  Based on suggestion  Progressive relaxation 4 The R. copyright infringement and violation of related laws in connection with the contents of the materials.4. actions or suits in connection with the contents of the materials of this compilation. makes no representations about the accuracy. and reliability of this compilation. A. It had no participation and compilation thereof such being sole responsibility of the reviewer concerned. authenticity. shall not be liable for any complaints. It declaims any and all responsibility or liability for plagiarism. Gapuz Review Center Inc.Guided Imagery  Imagine that you are walking along a peaceful shore  Eyes are closed and suggestions are given 5.