Basics of diagnosing and assessing pain are similar to that of any other medical complaint. Pain is one of the most common complaints faced by primary care practitioners. Diagnosing and assessing pain requires focused attention on the specifics of methodology. There are certain core questions that need to be answered by the patient as a part of pain assessment.
Categories of Pain
Nociceptive pain is experienced by all of us, and it signifies impending injury, tissue irritation, or actual injury. The nociceptors in the injured area get activated, and transmit the signals via spinal cord and peripheral nerves to the brain. Neuropathic pain arises due to malfunction in the nervous system.
Data gathering process is one of the most important aspects of diagnosing and assessing pain. Some of the basic questions that need to be addressed are how the pain developed, location of the pain, description of the pain, patient’s level of impairment and function, pattern of pain over time, and previously attempted treatments.
In case of diagnosing and assessing pain, there are not many tests available to make the diagnosis. The clinician relies on the presenting signs and symptoms, and initial diagnosis is based on the history. Selection of primary diagnosis is based on the physical exam, and sometimes, the tests are done to confirm the diagnosis.
While diagnosing and assessing pain, it is important to warn the patient when approaching the potentially painful areas. When examining the patients of opposite sex, it is a good policy to use a chaperone. For diagnosing and assessing pain, some of the common tests include mental status exam, vital signs, alpation and Musculoskeletal exam, neurologic, and sensory dysfunction.
Clinical diagnosing and assessing pain, which has been chronic, is a dynamic process involving specific goals leading to implementing and ongoing refinement of targeted management plan. It is essential to not rush through the assessment in order to provide immediate relief to the patient. Diagnosis must be established, and treatment must be aimed at providing the short-term and long-term relief while minimizing the side-effects.
Several tools have been developed and validated for assistance in diagnosing and assessing pain. The easiest ones to use have limited value as they only measure the intensity of pain.Multidimensional tools can assess different aspects of pain such as frequency, intensity, impact on quality of life, temporal nature etc. However, these tools are time-consuming, are more difficult to complete and require interpretation by experts.
For the effective short and long term treatment of any kind of pain, a thorough procedure for diagnosing and assessing pain is required. This can be done with the help of patient self-report, numerous assessment tools, physical examination and laboratory and diagnostic testing.