ACUTE PAIN: SELF-TEST
1. What quality of pain is transmitted by the unmyelinated C fibers?
A. Burning, itching, aching, poorly localized
2. Do the C fibers lie in the superficial or deeper parts of the dorsal horn? Is this relevant in the context?
A. Deeper. This is where the neurons of pain memory are (the wide dynamic range neurons). Once these neurons are "wound up" for a period of time, elimination of pain becomes difficult.
3. Are prostaglandins present both peripherally and in the central nervous system? Is this relevant?
A. Yes. Indicates that NSAID's have both peripheral and central actions on pain.
4. How is acetaminophen thought to decrease pain?
A. By decreasing excitatory pain neurotransmitters in the spinal cord (principally substance P and glutamate)
5. Name three different non-pharmacological methods or treating pain?
A. TENS, ice, Rubbing, Distraction
6. Why is the quantification of a patients pain and function important?
A. To assess the impact of pain on the patient's life and their response to therapy.
7. On the scale of 0 to 10 what sort of pain would be classified as mild 4, 6, or 8?
A. 4
8. How can the completion of pain diaries be made easier for the patient?
A. Keep diaries only on specific brief periods of time; limit entries to specific events e.g. headaches or times e.g. a.m. noon p.m. Ensure the patient understands their need in formulating a treatment plan. If the patient is not involved compliance will not occur.
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