How to identify and assess pain
Pain is a signal from the central nervous system that something is wrong in the body. It is a helpful mechanism that alerts the brain to take action. Without the ability to feel pain, we could sustain injuries or have serious medical conditions without realizing that our bodies are in danger.
Chronic pain, however, is an entirely different experience. It may be a medical condition symptom or have no identifiable cause at all. Most of us have experienced pain at some point in our lives, and we often use various terms to describe it, such as dull, acute, shooting, burning, sharp, or throbbing. However, people can understand these descriptions differently, and their interpretation of the pain scale can vary widely from one person to another.
Diagnosing pain levels medically is challenging, as it largely depends on personal experience. A particularly empathetic doctor may better understand a patient’s pain, but most rely on anecdotal descriptions to gauge the level of pain someone else is feeling.
Source: Pain Scale
Types of Pain
Most pain can be separated broadly into two buckets – acute or chronic
Acute pain is usually sudden, can be attributed to a specific trauma, and can generally be resolved in a set amount of time. There are three primary types of acute pain. If your loved one is in pain, it is important to see if they can determine which type they are experiencing.
Somatic pain:
A person experiences superficial pain on the skin or the soft tissues just beneath the skin. This pain typically results from bruising or contusions caused by a fall or other accident.
Visceral pain:
This pain comes from internal organs and the linings of body cavities. It may indicate a more serious underlying disease or injury.
Referred pain: Referred pain happens when a person feels pain in a different area of the body from where the actual tissue damage is occurring. For example, during a heart attack, individuals often experience pain in their shoulder. If you cannot identify a specific accident or trauma, it is important not to assume the source of the pain or the appropriate treatment before consulting a doctor.
Chronic pain is typically persistent, lasting for months or years, and disrupting daily activities. It affects around 100 million American adults, nearly half of whom find their work or daily life significantly impaired. Because chronic pain often does not originate from a specific condition, it is crucial to ensure that your loved one’s medical team includes a doctor who understands the complexities of non-specific pain and can explore alternative treatment options.
Source: American Chronic Pain Association and Centers for Disease Control
Pain Scales
Often, the best way to track pain is to track it over time. Does the pain have an ebb and flow? Is it associated with any specific activities? Has non-specific pain been occurring for a while? Some of the questions that a doctor might ask that you can also pursue with your loved one include:
How would you describe the pain (burning, stinging, stabbing, throbbing…)?
Where do you feel the pain, and has it spread?
Which activities aggravate and relieve the pain?
Are there times of day when the pain is worse?
How long have you been experiencing it? Add block
You can also use one of several scales to help your loved one
Identify levels of pain.
- Numerical Scale: The most commonly used scale, where pain is ranked from 0 (no pain) to 10 (worst possible pain).
- Visual Faces Scale: This format involves showing several faces with a range of expressions from distressed to happy to allow them to point at how they are feeling.
- General Pain Assessment: This assessment uses an outline of the human body, front and back, to have them place x’s where pain is located. This can facilitate conversation about whether the pain is linked or non-specific.
- McGill Pain Questionnaire: Doctors may use this official questionnaire, which uses groups of words to describe pain such as “tugging, pulling, wrenching” or “dull, sore, hurting, aching, heavy.”
Knowing where your senior hurts, how bad they perceive the pain to be, and how much it’s impacting their daily life is helpful both to aid you in knowing how to assist them, but also as an aggregated set of information to relay to their medical team.
Source: Medical News Today and Pain Scale
Non-Verbal Pain Cues
If your loved one is
cognitively impaired, there
are still ways to determine
that they are in pain. Here
are some examples of cues to pay attention to if they are not in their normal state of being.
• Restlessness
• Crying, moaning, and
groaning
• Resistance to care
• Increased wandering
• Sleeping or eating problems
Source: Medical News Today
Non-Drug Pain Treatments
There are several non-drug
therapies that may be more
suitable for those with chronic
pain. Examples include:
• Acupuncture
• Psychotherapy
• Chiropractic
• Heat and cold
• Exercise
• Massage
• Vitamin or herbal supplements
Source: Medical News Today
