4 Stages of Nociceptive Pain Processing

• Transduction

  

• Transmission

  • DRG
  • *Face: spinal trigeminal nucleus, chief sensory nucleus of trigeminal nerve
  • Common NTs

• Perception

• Modulation

  • Gate Control Theory
  • Descending inhibitory signals

• Pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociceptors

  • i.e. A-delta (myelinated) and C-fibers

• Q: Aching, throbbing, stiff

• Localized

• Can be elicited in physical exam

Management

• First-line:
  • NSAID
  • Acetaminophen (Tylenol®)
• Second-line
  • Opioid (Narcotics)

Nociceptive Pain Management in Palliative Care