Pain Assessment

p.483 The cell bodies of primary-order neurons or pain-transmitting neurons reside in the dorsal root ganglia just lateral to the spine along the sensory pathways that penetrate the posterior part of the cord. The second order neurons are found in the dorsal horn (p.484) Most nociceptive information tranvels by means of ascending columns in the lateral spinothalamic tract (also called the anterolateral funiculus). The principal target for nociceptive afferents is the thalamus (the major relay station of sensory information in general) Third order neurons project to portions of the CNS involved in the processing and interpretation of pain, the chief areas being the reticular and limbic systems and cerebral cortex. (p 484)

The perception of pain and the emotions that control intensity differ in individuals. Since feeling pain is somewhat adaptive, when one experiences it, he or she becomes aware of an injury and tries to remove oneself from the source that caused the injury. For this reason, pain is considered neuropathic or inflammatory in nature. Thus, when pain is the outcome from the damage caused to the neurons of the peripheral and central nervous system, then that pain is neuropathic. However, if the pain signals any kind of tissue damage, then the pain is inflammatory in nature. Due to various types of pain, the interpretation of pain by neurons and the source of that pain

As young adults, many of us may feel immune from ailments typically associated with the elderly. However, injuries can be unexpected, my cousin had a stroke at the age of 23. She assumed her headaches, the fuzzy feeling in her eyes, the numbness on her left side and her heart palpitations were due to fatigue. When she tried to get up

“Playing with Pain,” by Michelle Crouch in December, 2016, teaches us that focusing too much on one sport is not very good. Studies show that specializing in one sport actually has the opposite effect of what people think or say about it. Crouch write in the article about the experiences of Kellen Sillanpaa, a young athlete. The central idea is that if a person specializes in only one sport, there could be consequences. Some of the consequences are having pains, not being able to play a sport or do normal activities, and having a lower chance of success later in life.

H., Bell, J., Karttunen, N. M., Nykänen, I. A., M., & Hartikainen, S. A. (2013). Analgesic Use and Frailty among Community-Dwelling Older People. Drugs & Aging, 30(2), 129-136. doi:10.1007/s40266-012-0046-8. The purpose of this study was determine if frailty played a part in susceptibility to increased pain levels with adverse effects related to inadequately treated pain. The goal was to determine if there was different analgesic (prescription and nonprescription) use among varying level of determined frailty. Frailty levels of participants were determined using the Cardiovascular Health Study (CHS) regards to weight loss, low physical health, weakness, slowness and exhaustion. Participants were classified as robust, pre-frail or frail. The participants defined as robust had none of the CHS

Measuring Pain 1. 1. Sensory - intensity, duration, threshold, tolerance, location, etc 2. 2. Neurophysiological - brainwave activity, heart rate, etc 3. 3. Emotional and motivational - anxiety, anger, depression, resentment, etc 4. 4.

Pain can be categorized as acute or chronic pain. Chronic pain is described as pain that is both long-term and continuous, or is pain that persists after the expected healing time following an injury (British Pain Society, n.d.) Acute pain can provide a warning signal that an illness or injury has occurred. It is defined as pain that lasts less than three months and lessens with healing (Briggs, 2010). Acute pain can then be described in more detail by the following categories; somatic, visceral and neuropathic pain. Somatic pain is a localized pain described as sharp, burning, dull, aching or cramping. It is seen with incisional pain and orthopedic injuries or procedures. Visceral pain refers to an injury to the organs and linings of the body cavities. It produces diffuse pain and can be described as splitting, sharp or stabbing. This is pain that be described from patients with appendicitis, pancreatitis or intestinal injuries and illnesses. Injuries to the nerve fibers, spinal cord and central nervous system cause neuropathic pain. This pain can be described as shooting, burning, fiery, sharp, and as a painful numbness. This can be seen after an

As with all older adults, clients with dementia present with chronic conditions such as arthritis and acute pain experienced in the aging and the end of life process. Moss (2002) gives evidence that most elderly clients who move into long-term care will die in an institution either a nursing home or a hospital many of whom will have dementia. She states that 91% have a strong co morbid condition likely to cause pain.

Dealing with aging dementia patients can be a challenge in and of itself. However, when healthcare providers need to include regulating pain as well, the challenge becomes even greater. Pain management with cognitively impaired patients is a constant problem within geriatric care in modern healthcare facilities (Zwakhalen et al 2006). The reduced self capacity to report pain in its true degrees then makes pain management a challenge for physicians and healthcare providers (Husebo et al. 2007). Thus, research aims to explore effective measures for observing and reporting pain management within aging dementia patients.

As we age, our brain and nervous system go through natural changes. An aging adult may experience memory loss, decreased touch sensation, change in the perception of pain, change in sleep pattern, decreased coordination and increased risk for infection (Ignatavicius, 2013, p. 912) .

Outcomes and Key Results: Likely that people with dementia are often under medicated because they are not able to adequately describe their pain symptoms. Age and age related pain are the highest factors for both dementia and pain; pain management, though, may be skewed.

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.

As people grow older, they develop dental problems which lead to nutritional intake issues. Cognitive function declines affecting memory, decision making, conversing, and problem solving. In addition, falls can occur with mental status disturbances. Lack of social interaction, depression, and anxiety also crop up in the elderly. Sleep patterns are altered by restless legs, snoring, and disrupted breathing sequences. At times, pain can be constant from arthritis, osteoarthritis, or other medical issues (Tabloski, 2014).

The current standard for assessing infants' pain is inconsistent and intermittent and needs machine-based techniques to provide consistent and continuous assessment. The automated assessment of pain has three main stages, preprocessing, pain analysis or feature extraction, and pain recognition. This paper presents a comprehensive review of the automated methods for pain analysis and recognition. It also gives descriptions of the databases that are available to researchers, discusses the current limitations of automated pain assessment systems, and suggests directions for future

Based on the duration of persistence, pain is often divided into two broad categories as mentioned below.