Pain and Behavior: Objectives - Understand Purpose of Pain - Pain Pathway - Differences On Different Individuals

Pain and behavior
Objectives
• Understand purpose of pain

• Pain pathway
• Differences on different individuals
Introduction
• Pain is one of the most common complaint
by patients
• It is therefore important to have a thorough
understanding pain
Definition
•Pain is the body’s way of telling us

that something has gone wrong.
•It draws our attention to a burn,
break, and rupture and tells us to
change our behavior immediately.

Differences
• The few people who are born without the
ability to feel pain experience severe injury
without ever being alerted by pains danger
signals.
• Some people endure chronic pain.
• Pain is not only a property of the senses of
the region we feel it but of the brain as well.
Phantom limbs
•People who have had limbs
amputated may feel pain in their non-
existent limbs. This is called phantom
limb.
• These phantom limb sensations
indicate that with pain, as with vision
the brain can interpret incoming
neural activity, as something is not.
Compare with vision
• Unlike vision, however, the pain system is
not located in a simple neural cord running
from a sensing device to a definable spot in
the brain.
• Moreover there is no one type of stimulus

that triggers vision and there are no special
receptors (as the rods &cones of) the retina.
Stimuli intensity
At low intensities, the stimuli that
results in pain causes other
sensations:- including
• Warmth
• Coolness
• Smoothness
• Roughness
Gate control theory
Ronald Malzack (psychologist) and

biologist Patrick Walls (1965, 1983)
proposed the gate-control theory,
which remains the most important
model.

Gate control theory
• Melzack and Wall believe that the spinal
cord has a sort of neurological gate that
either blocks or allow pain signals to pass to
the brain.
• The spinal cord contains small diameter
nerve fibers that conduct most signals and
larger fibers that conduct other sensory
signals from the skin.
Gate control theory
•When tissue is injured, the small

diameter fibers active and you feel
pain.
•Activities in the large fibers tend to
close the pain gate turning pain off.
Gate control theory
• This is the basis of treatment for chronic
pain by electrical stimulation and massage.
•
• The pain gate can also be closed by
information that comes from the brain.
Thalamus
• Thalamus is involved with perception of pain.
• The nociceptors (pain receptors receive nerve
impulses from the peripheral organs
• The impulses are then relayed and eventually
ascend along spinothalamic and reticulothalamic
tracts to the thalamus.
• from the thalamus the impulses are relayed to the
somatic sensory cortex.
Thalamus as arelay station
• The Thalamus is a relay station for all of the
sensory messages that enger the brain.
• It is this area that the conscious awareness
of messages as sensations such as
temperature, pain and touch probably begin
• Dysfunctions of the thalamus are due to
many factors including tumours which
produce severe pain syndrome
Psychological influence on pain
• The brain to spinal cord messages helps
explain some striking psychological
influences on pain.
• A footballer may suffer an injury
yet feels no pain until off the field.
• When not attending to pain
signals, our experience of pain may
greatly diminished.

• Pain can stimulate release of the pain
killing endorphins- involved in modulation
of pain.
• Pains behaviors are reinforced when
rewarded are inhibited when ignored or
punished.
• Pain is associated with emotional
distress, which may worsen it.
Pain control
•Pain is both physical and
psychological phenomenon.
•Treatment should therefore be
through physical and psychological
therapies.
Control of pain.
Pain can be controlled through;
• Drugs surgery
• Electrical stimulation
• Massage
• Exercise
• Relaxation training
• Thought distraction
Lamaze method
The widely used Lamaze method of
prepared childbirth combines several
of these pain control techniques.
Lamaze method
it involves;
• Relaxation (through deep breathing
and muscle relaxation)
• Distraction (through focusing
attention on-say a pleasant
photograph).
• Counter stimulation (through
gentle massage especially when done
by intimate person like a husband.
Pain tolerance
Pain tolerance is increased by
distracting people pleasant images or
drawing their attention from painful
stimulation (e.g. count backward by
three’s).

Pain control
• The same principles operate in health care
institution a well-trained nurse will distract
needle-shy patients with chatter and may
ask them to look away
Pain control
• Poger Ulrich (1984) discovered that surgery
patients assigned to room that looked out on
trees require less pain medication and had
shorter stays than did those assigned to
identical rooms that overlooked a brick
wall.
Psychological pain disorder
Some individuals develop pain

disorder whose primary symptom is
presence of pain in one or more sites
that is not fully accounted for by a
medical or neurological condition.
Ctd
Treatment of psychological pain requires

not just medication but also psychological
treatment( psychotherapy)
conclusion
• It is important to evaluate pain and
determine whether its etiology is organic,
psychological or both.
• This enables you as the clinician to manage
patients properly

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Pain and behavior

• Understand purpose of pain

•Pain is the body’s way of telling us

• Moreover there is no one type of stimulus

Ronald Malzack (psychologist) and

•When tissue is injured, the small

Some individuals develop pain

Treatment of psychological pain requires

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