Pain Modulation Mnemonics [Remember Easily]

Pain Modulation Mnemonics :

• P – Pain is variable: The pain experienced by individuals in response to injuries of similar magnitude can vary significantly, depending on a range of factors such as the situation, individual perception, and psychological variables.

• A – Analgesic effect of suggestion: The suggestion that a treatment will relieve pain can have a significant analgesic effect, as demonstrated by the placebo effect. Expectation and attention can also activate endogenous opioids, resulting in pain relief.

• I – Individual perception of pain: Even individuals who have sustained serious injuries may not experience severe pain, while others may find even minor injuries such as venipuncture unbearable. Perception of pain can be influenced by a range of psychological variables, including expectation and attention.

• N – Nocebo effect increases perceived pain: Just as the suggestion that a treatment will relieve pain can have an analgesic effect, the suggestion that pain will worsen following the administration of an inert substance can increase its perceived intensity, as demonstrated by the nocebo effect.

• M – Modulation of pain-transmission pathways: Brain circuits modulate the activity of pain-transmission pathways, controlling spinal pain-transmission neurons through a descending pathway. This pain-modulating circuit is implicated in the pain-relieving effect of attention, suggestion, and opioid analgesic medications.

• Opioid receptors and peptides: The component nuclei of the pain-modulating circuit contain opioid receptors and endogenous opioid peptides, such as the enkephalins and β-endorphin. Lesions of this system reduce the analgesic effect of systemically administered opioids such as morphine.

• D – Descending pathway controls spinal neurons: The descending pathway, which has links to the hypothalamus, midbrain, and medulla, selectively controls spinal pain-transmission neurons, thereby modulating the activity of pain-transmission pathways.

• U – Unbothered by injuries in certain situations: Soldiers in battle may not be bothered by injuries that would produce agonizing pain in civilian patients, while athletes have been known to sustain serious fractures with only minor pain. These examples illustrate the variability of pain perception in different situations.

• L – Lesions of descending system reduce opioid effect: Lesions of the descending pain-modulating system reduce the analgesic effect of systemically administered opioids such as morphine.

• A – Attention and emotion can activate endogenous opioids: The most reliable way to activate the endogenous opioid-mediated pain-modulating system is through suggestion of pain relief or intense emotion directed away from the pain-causing injury.

• T – Theory: pain signal can be generated without peripheral stimulus: Pain-transmission neurons can be activated by modulatory neurons, making it theoretically possible to generate a pain signal without a peripheral noxious stimulus.

• I – Increased activity in circuit during migraines: Human functional imaging studies have demonstrated increased activity in the pain-modulating circuit during migraine headaches, suggesting a central circuit that facilitates pain.

• O – Overall, psychological factors can contribute to chronic pain: Psychological factors, including expectation, attention, and emotional state, can contribute to the perception and modulation of pain, and may play a role in chronic pain conditions.

• N – Noxious stimulus is not always necessary to generate a pain signal as modulatory neurons can activate pain-transmission neurons.

Mnemonic: “PAIN MODULATION“