Assessing Pain

Clear pain assessment and documentation is critical to maintaining good patient-professional communication. Healthcare professionals should conduct thorough assessments and help their patients in assessing pain and disclosing all details of their condition and history. Talking and listening to one another at this stage creates a trusting, collaborative environment to develop the most appropriate and effective pain management treatment plan. Clear pain assessment and documentation is critical to maintaining good patient-professional communication. Healthcare professionals should conduct thorough assessments and help their patients in assessing pain and disclosing all details of their condition and history. Talking and listening to one another at this stage creates a trusting, collaborative environment to develop the most appropriate and effective pain management treatment plan.

Most hospitals, nursing homes and other healthcare facilities are now required to perform pain assessment and treatment. In assessing pain, your healthcare professional may:

It's important for your healthcare professional to have a complete picture of your pain history. He/she may ask about seven characteristics of pain to help LOCATE your pain and make the correct diagnosis.

L the exact Location of the pain and whether it travels to other body parts
O Other associated symptoms such as nausea, numbness, or weakness
C The Character of the pain, whether it's throbbing, sharp, dull or burning
A Aggravating or Alleviating factors. What makes the pain better or worse?
T the Timing of the pain, how long it lasts, is it constant or intermittent?
E the Environment where the pain occurs, for example, while working or at home

Pain scales are additional pain assessment tools to help you describe the intensity of your pain and help your doctor or other healthcare professional diagnose or measure your level of pain. These include numeric, verbal or visual scales.

With numerical scales, you use numbers from 0-10 (0 being no pain and 10 being the worst pain ever) to rate the intensity of your pain.

Verbal scales are pain assessment tools that contain commonly used words such as "mild", "moderate" and "severe" to help you describe the severity of your pain.

Visual scales are pain assessment tools that use aids like pictures of facial expressions, colors or gaming objects, such as poker chips, to help explain the severity of your pain. One type, the Wong Baker Faces Pain Rating Scale, shows six different facial expressions from happy (no hurt) to agony (hurts the worst) to help show your healthcare professional how much pain you feel. Body diagrams may also be used to help pinpoint where your pain occurs.

Multidimensional pain assessment tools, such as the McGill Pain Questionnaire (MPQ) and the Brief Pain Inventory (BPI), have been developed to quantitate different aspects of pain, including location and quality of pain and its effect on mood and function. However, these take longer to administer than the simpler scales and some patients who are cognitively impaired or poorly educated may find them difficult to complete. They are generally used in pain research but can be adapted for clinical use in assessing pain, if appropriate and valuable.

For other valuable patient resources for assessing pain, see our free pain journal and other pain assessment tools such as the Let's Talk Pain show.