9990 · 3.3.3
Managing and controlling pain flashcards
Revision flashcards for Cambridge 9990 Managing and controlling pain (syllabus 3.3.3). Flip, recall, then mark a real past-paper question.
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NSAIDs mechanism?
Non-steroidal anti-inflammatory drugs (e.g. ibuprofen) — reduce **prostaglandins** at injury site; effective for inflammatory pain, not neuropathic.
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Opioid risk?
Strong analgesia but **tolerance**, **dependence**, and **respiratory depression** — opioid crisis highlights addiction risk in chronic use.
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TENS and gate control?
Transcutaneous Electrical Nerve Stimulation activates **large-diameter fibres** — closes spinal gate per **Melzack & Wall**; non-invasive, patient-controlled.
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CBT for chronic pain?
Cognitive Behavioural Therapy targets **catastrophising** and helplessness — changes pain-related thoughts and behaviours; no effect on tissue damage but reduces **disability**.
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Distraction technique?
Directing attention away from pain (music, games, VR) — reduces pain perception via **gate closure** and limited attentional capacity.
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Multimodal pain management?
Combining **pharmacological + physical + psychological** approaches — standard for chronic pain where single-method treatment fails.
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What is the primary mechanism of opioid analgesics like morphine?
They bind to opioid receptors in the central nervous system (brain and spinal cord), mimicking the body's natural endorphins to block the transmission of pain signals and alter pain perception.
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According to the Gate Control Theory, how does TENS work?
TENS stimulates large A-beta nerve fibres. This activity 'closes the gate' in the spinal cord's dorsal horn, preventing pain signals from smaller A-delta and C fibres from ascending to the brain.
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What is 'catastrophising' in the context of CBT for pain?
It is a maladaptive cognitive pattern involving rumination, magnification of the threat value of pain, and feelings of helplessness. CBT aims to identify and restructure these thoughts.
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What is the core principle behind distraction as a pain management technique?
The principle of limited attentional capacity. By focusing attention on a non-painful stimulus (e.g., a video game), fewer cognitive resources are available to process and perceive the pain signals.
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Define multimodal pain management.
A holistic, integrated approach that combines multiple treatment methods (e.g., biochemical, physical, and psychological) to address the various biological, psychological, and social aspects of a patient's pain.