1. The Nature & Symptoms of Pain
Chapter 11
Dr. Alan H. Teich

2. Qualities & Dimensions of Pain
Organic pain vs. Psychogenic pain
Acute vs. Chronic Pain

3. Qualities & Dimensions of Pain
Chronic pain
Benign vs. Malignant
Continuous vs. Episodic
Types
Chronic/recurrent
Chronic/intractable/benign
Chronic/progressive

4. Assessing Pain Self-Report Methods Questionnaires
Behavioral Assessment
Physiological Measures

5. Personal & Social Experiences and Pain
Learning
Emotions

6. Physiology of Pain Perception
Noxious stimulation release of algogenic substances at the site
e.g., serotonin, histamine, bradykinin
Algogenic substances promote immune system activity (inflammation)
Inflammation activates free nerve endings signaling pain
Free nerve endings: nociceptors

7. Physiology of Pain Perception
Afferent peripheral fibers
A-delta fibers
C fibers

8. Pain Without Apparent Physical Basis
Types
Neuralgia
Causalgia
Phantom Limb Pain

9. Theories of Pain
Specificity Theory
Pattern Theory
Gate Control Theory

10. - - Theories of Pain Gate Control Theory + + + + Brain
Small A-delta & C fibers + + +
Substantia Gelatinosa
(“The Gate”) -
Transmission cells (T cells) - +
Large A-beta fibers

11. - Theories of Pain + Basbaum & Field’s Descending Analgesic Pathway
Opiates inhibit inhibitory neurons of PAG
Theories of Pain
Basbaum & Field’s Descending Analgesic Pathway
Periaqueductal
Grey
disinhibition +
Interneurons
Raphe Nucleus -
Spinal Cord
Incoming Pain Signals
Ascending Anterolateral Pathway to brain