Pain Assessment

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Pain Assessment
Pain Assessment

• Basics for Non-Healthcare Providers
• The Iowa Pain Management Initiative

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Why Should I Care?

• Pain robs you of pleasure in life
• Long-term pain can actually have harmful effects
  all by itself
• Its easier to prevent or lessen pain than to
  treat it once it has become severe
• Youre doctor doesnt know youre in pain until
  you tell him or her

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Barriers to Pain Assessment--Physicians

• Lack of pain management training in medical
  schools
• Lack of pain assessment skills
• Unwillingness to change prescribing practices
• Fear of regulatory oversight
• Inappropriate fear of addiction

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Barriers to Pain AssessmentPatients

• Reluctant to report pain
• Reluctant to take narcotics
• Poor adherence to prescription
• Dont want to ask
• Inappropriate fear of addiction

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Barriers to Pain Assessment--System

• Low priority given to symptom control
• Unavailability of narcotics
• Inaccessibility of specialized care
• RN staffing shortages
• Lack of insurance coverage for pain medications
  outside the hospital
• Inappropriate fear of addiction

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Goals of Pain Assessment

• Describe the pain
• Evaluate physical, emotional, and psychological
  aspects of pain
• Determine the degree and nature of any disability
• Develop an approach for pain management

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Comprehensive Pain Assessment

• Historywhere is the pain, how long have you had
  it, what does it feel like
• Physical examination
• Appropriate laboratory and radiologic tests

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Pain Assessment Tools

• Verbal rating scale
• Numeric scale
• Scales for children

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Types of Pain

• Pain related to tissue injuryeg, cancer
• Pain related to problems in the nervous
  systemeg, shingles
• Pain that doesnt seem to have an identifiable
  cause
• Pain caused, maintained, or made worse by
  psychological factorsstressors

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Pain Syndromes

• Acute pain (like surgery)recent onset,
  transient, identifiable cause
• Chronic pain (like lower back pain)Persistent or
  recurrent pain, beyond usual course of acute
  illness or injury
• Breakthrough pain (arthritis flare-ups)transient
  pain, severe or excruciating, over baseline pain

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Examples of Additional Pain Syndromes

• Cancer pain syndromesbone pain, broken bone,
  spinal cord compression, bowel obstruction
• Noncancer-related pain syndromesfacial pain,
  low-back pain, chronic tension headache, chronic
  pelvic pain with unknown cause

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Talk to Your Doctor

• Your doctor cant know you are in pain unless you
  tell him or her
• There are strong medications available to treat
  pain
• There are non-medicine ways of treating pain