Pain Assessment
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Pain phases[edit | edit source]
When assessing pain it is important to recognise the differences between acute and chronic pain and the implications for assessment and management of the patient. each of these phases presents:
- Acute - In the acute pain phase performance of a comprehensive assessment using reliable and validated tools to prevent the onset of chronicity is of utmost importance.
- Subacute
- Chronic
Pain assessment[edit | edit source]
When assessing pain we use a biopsychosical approach for assessment of pain and disability as it accounts for the multidimensional nature of pain in domains relevant to physical therapy practice.
A biopsychosocial assessment should seek to identify the following:
- Bio (triage and identification of the pathology)
- Psycho (psychological distress, fear/avoidance beliefs, current coping methods and attribution)
- Social (work issues, family circumstances and benefits/economics)
During our assessment we must account for the multidimensional nature of pain by including appropriate assessment measures for primary domains including:
- Sensory
- Affective
- Cognitive
- Physiological
- Behavioral
Pain measures[edit | edit source]
Commonly used measures for different pain dimensions include:
- Self-report measures
- Physical performance measures including Functional Capacity Evaluations (FCEs)
- Physiological/autonomic response measures
These measures each have their own strengths and limitations for different pain dimensions which we must recognise:
Self report measures[edit | edit source]
- Numerical Rating Scale
- Visual Analogue Scale
- Patient Global Impression of Change
- The short-form McGill Pain Questionnaire
- Brief Pain Inventory short form
- West Haven-Yale Multidimensional Pain Inventory
- Treatment Outcomes of Pain Survey
Individualised assessment[edit | edit source]
It is important to modify pain assessment strategies to match inherent variability associated with the patient's clinical presentation:
- Individual factors (e.g. age, sex, etc.)
- Sociocultural influences (e.g. spirituality, ethnicity, etc.)
- Clinical characteristics of pain (e.g. duration, anatomical location, etc.)
- Pain type and state (e.g. neuropathic pain, cancer pain, etc.)
- Vulnerable populations (e.g. communication barriers, cognitive impairment etc.)
Outcomes of pain assessment[edit | edit source]
Following assessment of pain suitable management strategies can be implemented. However, as always, it is important to understand the need to:
- monitor and review the effectiveness of treatment/management and modify treatment and management strategies appropriately.
- refer to relevant health professional as appropriate and in a timely manner.
Resources[edit | edit source]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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