Pain: Methods for the Assessment

Abstract

International Association for the Study of Pain defines pain as an unpleasant subjective sensation that includes the past experiences of the person with or without tissue damage. Acute pain, generally lasting for hours to days, is the primary complaint at a rate of up to 70-80% at first admission. Headache, myalgia, arthralgia, back pain, local pain induced by minor trauma (such as sprains), thoracoabdominal pain, ear, facial pain, etc. are the most common types of presentations in the acute setting related to pain. Analgesia, on the other hand, is the relief of the perception of pain without causing sedation or any change in vital signs. It is one of the few areas a physician can make a difference to implement more efficient patient care. The subjective and multidimensional nature of the pain experience make pain assessment really challenging. Patients’ evaluation of pain should be the main reference for decision-making to provide analgesics or not. Implementation of dimensional recording of pain in clinical practice include the addition of pain as the “fifth” vital sign to be noted during initial assessment; the use of pain intensity ratings; and posting of a statement on pain management in all patient care area. Our motto should be “pain cannot be treated if it cannot be assessed”. The most important principle is that clinicians should somehow assess their patients' pain levels, independent of the specific method or scale to achieve this. Although all pain-rating scales are valid, reliable and appropriate for use, the VAS has somehow appeared more difficult than the others. Pain reassessment should be guided by pain severity reported by the patients themselves.