Pain assessment

Abstract

Pain accounts for the most common presenting symptom in visits to the doctor's office, and is estimated to be prevalent in 30% of the American adult population. The expenses involved in managing chronic pain are not only limited to traditional healthcare services but include also indirect costs such as poor work performance, disability compensation, and legal services. The appropriate assessment of a chronic pain patient is essential to determine an accurate diagnosis and the most effective treatment strategies. Given the multifactorial nature of chronic pain states, the initial evaluation of these patients requires a comprehensive approach, not only to identify possible organic etiologies but also the emotional and social factors associated to the patient's symptoms. To obtain information of relevance in the most efficient way, the initial assessment of a chronic pain patient will involve a thorough history and a general physical exam with more detail into the area of painful symptomatology. The use of standardized assessment tools will complement the patient's report and guide toward the need for more specific interventions. Additional to this, the selection of an appropriate diagnostic test will also help to accurately confirm the diagnosis, and can evaluate the extent of structural pathology associated with the patient's symptoms.