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A thorough evaluation of pain is the foundation for developing a rational treatment plan2,3. Unless a thorough pain assessment is performed, patients are at risk of receiving suboptimal treatment2.
A comprehensive assessment of pain includes2:
- Taking a detailed patient history
- A physical examination (including a neurological examination)
- A psychosocial assessment
- Diagnostic testing (e.g. imaging) when appropriate.
Taking a detailed patient history
The patient’s pain history should document the location, duration, type and intensity of the pain, any exacerbating or alleviating factors, previous treatments and response, the impact on the patient and their family, and any barriers which may prevent effective treatment2.
Assessment checklist
Figure 2 contains a preliminary checklist of factors to consider when interviewing a patient presenting with chronic, persistent or prolonged pain.
Adapted from Cepeda MS et al, “Fast Facts: Chronic Pain” Health Press, 20072 and Analgesic Therapeutic Guidelines5
Note: Appendix 1 contains a comprehensive list of general questions to ask the patient when documenting the patient’s pain history.
General questions to ask
There are a large number of questionnaires available to help clinicians better assess chronic or persistent pain. The patient’s self-report is a more accurate assessment of pain than are vital signs, outward behaviour or observer estimates1.
Alternatively, these questions may be adapted as required by the clinician as part of the clinical consultation to suit the individual needs of the patient. It should be noted that although questionnaires are useful as an assessment tool, they should be accompanied by a good clinical examination and interview1. More detailed psychosocial questionnaires are available on this website for assessing psychosocial aspects of pain.
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