Chronic pain is one of the common reasons for medical consultation. It is of complex natural history, unclear etiology and poor response to treatment. It causes significant morbidity, suffering, disability and over utilization of health care systems. CPS is a poorly defined condition. Most authors consider ongoing pain lasting longer than 6 months as diagnostic, and others have used 3 months as the minimum criterion. In chronic pain, the duration parameter is used arbitrarily. Some authors suggest that any pain that persists longer than the reasonable expected healing time for the involved tissues should be considered chronic pain. Several factors have been identified as having potential influence on patient’s perception of pain. These include …show more content…
A comprehensive pain history is important in understanding the patient’s problem situation and planning management,
The important elements of pain history
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Aggravating and alleviating factors: What factors aggravate the pain?
What brings about relief or attenuation of pain?
Associated features: What other symptoms are associated with the pain?
How does it affect your sleep? Your appetite? Your energy level?
Treatment history: What are the types of treatment obtained? What was the response? Any side effects with treatment? Investigations?
2. Associated dysfunction
Social dysfunction: Does the pain interfere in social functioning? Has the patient been avoiding social gatherings due to pain?
Activities of daily living: Does the pain interfere with activities of daily living like bathing, dressing etc.?
Occupation dysfunction: has the pain resulted loss of work? Absenteeism? Reduced efficiency at work?
Marital dysfunction: Has the pain affected your relationship with spouse?
Sexual dysfunction: Has there been any sexual dysfunction?
3. Psychological factors.
Chronic pain has high rates of psychiatric comorbidity. Chronic pain is associated with a number of psychiatric conditions. In many pain is the main presenting complaint. It has found to be the main presenting symptom in 45-60% of
Pain radiates from the lower back and aggravated by bending, getting in and out of the car, lifting, reciprocating stairs, sitting, standing, turning, twisting and walking which is mildly alleviated by over-the-counter drugs and
A patient is admitted to Nightingale Community Hospital to the surgical unit following an infection to a post-op wound. There were several deficiencies found on the patient’s tracer audit once the patient was admitted to the hospital. One deficiency that was found was that the patient was given medication related to pain and the patient was not reassessed properly per Joint Commission Standards (JC). The deficiency found is within the pain assessment policy of the hospital.
Activities at home and work worsen the pain. Numbness, tingling, and burning sensation are reported with increased pain throughout the week. The patient is requesting medication refills and reports limitations with gripping, grasping, pushing, pulling, and lifting 10 pounds. Activities of daily living are limited due to pain, as
In the article, “Sometimes Pain Is a Puzzle That Can’t Be Solved”, Abigail Zuger, the author, describes her own experiences with pain along with some examples and generalizations about the feeling. She claims that she is “ruled by (her) elbow” and “it is (her) constant companion, whimpering, and tugging at (her) sleeve.” She goes on to say that many people have the same problems, especially when drugs, “like naproxen and ibuprofen” are unhelpful and “might as well be cornflakes.” Finally, she explains how far we have advanced in the medical field, but “ none of (the) knowledge has translated into new treatments,” to help people such as herself.
Interestingly, social function was the most frequently selected domain with pain intensity, although participants did not consider social health as an important area as physical health, which was obviously supported by the results of the open-ended question and PROMIS cards parts of the interview. Social function was merged from two PROMIS domains; “ability to participate in social roles and activities” and “satisfaction with social roles and activities”. These two domains were combined because the participants had difficulty differentiating between them and therefore they only selected one of them during the interview. A systematic review showed that the social component of life was important for individuals with LBP 55. In addition, WHO reported that LBP affects the work performance among individuals with LBP and it considered a leading cause of work absence and loss 53.
I am so happy you picked pain as your ICP project. Pain, in my eyes, has always been all encompassing. It can affect sleep, ability to move around, eating, healing, breathing, mood and relationships (Shega, Tiedt, Grant, & Dale, 2014). Personally when I am in severe pain I really do not want people around and it affects every aspect of my life. To think that persistent pain affects 80% of elderly residents in nursing homes and 50% of community dwellers, and we still do not treat this properly (Veal& Peterson, 2015).
The patient stated that pain is relieved by medications and aggravated by sitting and standing. He rates the pain 4/10 at its best and 10/10 at worst. UDS and CURES report showed that
Considerable evidence demonstrates substantial ethnic disparities in the prevalence treatment progression and outcome of pain-related conditions. Elucidation of the mechanism underlying these group differences is of crucial importance in reducing and eliminating disparities in these pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of Healthcare system. That may contribute to shaping individual difference in pain. For example, the experience of pain differentially activate stress- related physiological response across various ethnic groups appear to use differing coping strategies in managing pain complaints treatment decision vary as a function
In this crosspost, the author will elaborate on the original threaded discussion by Ellerbee Mburu, Vail, and Barlow and add additional information on pain assessment and management. Healthcare providers are the major group of healthcare professional who perform crucial functions in delivering and providing nursing care to inpatient and outpatients. As mentioned in the threaded discussion by Ellerbee, Mburu, Vail, and Barlow, undertreated pain causes unnecessary distress and negatively affects the quality of life. In additional to the original threaded discussion, pain is a factor that is thought of differently by many. It has been added as the fifth vital sign and is considered to be subjective.
We all know that pain is usually one of the major complaint of patients with chronic problems or those recovering post operatively thereby making pain evaluation a fundamental requisite in the outcome assessment during hospital visits. Interpreting the data from a pain assessment scale is not as straightforward as it may seem since the provider must consider the intensity, related disability, duration, and affect to define the pain and its effects on the patient (Williamson & Hoggart, 2005). Pain rating scales are used in the clinical settings to measure pain and these include Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Numerical/numeric Rating Scale (NRS) (Haefeli & Elfering, 2006). Each scale is unique on its own in terms of sensitivity and simplicity that generates data that can be statistically analyzed for audit purposes. The EHR in our hospital utilizes the three rating scales mentioned as part of the pain assessment tool to measure pain that sets the tone for the direction of the type of pain management will .be given to the
Some patients prefer not to take pain medication because they fear addiction or may have a history of substance abuse. Educating the patients on their right to be free of pain and having their pain managed aggressively is a priority in the recovery phase. The goals that I hope to achieve during this clinical practicum
Psychological Assessment and Management of Chronic pain Evaluating a chronic pain condition from a biological perspective is limiting, and often fails to fully explain the patient’s symptoms. In contrast to the biomedical model, which explains pain purely in terms of pathophysiology, the biopsychosocial model views pain, suffering and disability, as the result of dynamic interactions among biological, psychological, behavioral, social, cultural and environmental factors. Consequently, assessment requires not only the examination of the biological dimension, but of the psychological and social dimensions as well. A patient’s experience of pain and response to any treatment for pain are affected not only by biologically determined nociceptive (nervous system transmission) processes, but also by psychological factors such as mood (for example, depression, anxiety) and appraisals (thoughts and beliefs about the pain), as well as by psychosocial factors such as the responses of others (for example, family, friends,
In more severe cases, pain will also worsen toward the end of the day
Low back pain is neither a disease nor a diagnostic entity of any sort. The term refers to pain of variable duration in an area of the anatomy afflicted so often that it is has become a paradigm of responses to external and internal stimuli (Ehrlich GE 2003). Research study on low back pain has shown that it is a common problem in general population. As seen in Western industrialized countries, back pain is one of the major health problems (R Ayiesah and D Ismail 2007).
Literature Review Physical therapy is the practice of healing various injuries with exercises instead of drugs. People have to attend physical therapy for various reasons, such as after facing a stroke, after a surgery, or if someone is experiencing pain anywhere in their body. From the International Association for the Study of Pain, pain can be defined as “an unpleasant sensory and emotional experience, unique to every individual, associated with actual or potential tissue damage” (Keefe, 2017). Many reports have shown that over 100 million Americans suffer from persistent pain, (Keefe, 2017). These people who are experiencing pain must be referred to a physical therapist’s office.