Pain is “the perception of a noxious stimulus that begins in the dorsal horn and involves the entire spinal cord and brain.”
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage, or both.”
Pain can be described in terms of sensory, emotional, and cognitive components. These 3 components of pain are reflected in the mechanisms of the transmission and modulation of painful stimuli. Such mechanisms are mediated through the nociceptor neurons, the spinal cord processes, and the cerebral or brain processes.
Many different taxonomies exist for the classification of pain. In the clinical setting, a physician must infer the pathophysiology of a pain syndrome from his or her patient’s clinical evaluation. The most common of these inferred pathophysiologies may be described as nociceptive, neuropathic, and mixed.
Types of Pain
Neuropathic Pain – Pain initiated or caused by aprimary lesion or dysfunctionin the nervous system(either peripheral or central nervous system).
Examples:
Peripheral
- Post-herpetic neuralgia
- Trigeminal neuralgia
- Diabetic peripheral neuropathy
- Post-surgical neuropathy
- Post-traumatic neuropathy
Central
- Post-stroke pain
- Common descriptors
- Burning
- Tingling
- Hypersensitivity to touch or cold
Mixed Pain – Pain withneuropathic andnociceptivecomponents
Examples:
Low back pain withradiculopathy
- Cervical radiculopathy
- Cancer pain
- Carpal tunnel syndrome
Nociceptive Pain – Pain caused by injury tobody tissues(musculoskeletal,cutaneous or visceral)
Examples:
Pain due to inflammation
- Limb pain after a fracture
- Joint pain in osteoarthritis
- Post-operative visceral pain
Common descriptors
- Aching
- Sharp
- Throbbing
Nursing Interventions for Pain
- 1. Asses pain every 2 hours using a 1-10 scale, pain scales provide a measure of pain which is consistent.
2. Observe for nonverbal signs of pain, are like: facial expression, posture, restlessness, crying / grimacing, withdrawal, diaphoresis, changes in heart rate / breathing, blood pressure.
3. Teach patient adverse complication of uncontrolled pain, it is important the patient understand why pain is treated so they will report discomfort.
4. Suggest to rest in a quiet room. Instruct patient to report pain immediately if the pain arises.
5. Teach patient deep breathing and visulization, these methods can reduce pain preception and return to the patient a feeling of control.
6.Teach patient that addiction to pain meds is not formed when medication is needed due to acute pain.
7. Massage the head / neck / arm if the patient can tolerate the touch.
8. Use the techniques of therapeutic touch, visualization, biofeedback, hypnosis itself, and stress reduction and relaxation techniques to another.
9.Instruct the patient to use a positive statement “I am cured, I’m relaxing, I love this life”. Instruct the patient to be aware of the external-internal dialogue and say “stop” or “delay” if it comes up negative thoughts.
10.Provide patient with distractions of choice such as TV, music or reading. Distraction can help to relieve pain.
Image by: palmettohealth.org
