Identifying and Assessing Pain
Pain is a signal from the central nervous system indicating that something is wrong. Pain is helpful in that it alerts the brain to take action. If we never felt pain, we could be injured or have a serious medical condition without any awareness that our body is in danger.
Unfortunately, chronic pain is an entirely different experience. It is often a symptom of a medical condition or has no known cause.
We have all likely experienced pain at some pint in our lives. There are a variety of common words to describe pain, sch as dull, acute, shooting, burning, sharp, or throbbing. However, people's understanding of these words and their position on the pain scale can vary wildly. There is no medical way to diagnose a level of pain, so often it hinges on our subjective experience. A larger challenge occurs when trying to describe someone else's pain. A particularly empathetic doctor might be better able to key into a level of pain, but most will rely on anecdotal descriptions to help them understand.
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 you are in pain, it is important to determine which type you are experiencing.
Somatic pain: this superficial pain on the skin or the soft tissues just below the skin. These are usually bruising or contusions from a fall or other accident.
Visceral pain: originates in the internal organs and the linings of cavities in the body. It can indicate a more deep-rooted disease or a more serious accident.
Referred pain: pain at a location other than the source of tissue damage. For example, people often experience shoulder pain during a heart attack. If you don't know of a specific accident or trauma, it is important not to assume the point of pain or treatment prior to talking with a doctor.
Chronic pain is generally pain that is ongoing for months or years and interferes with daily activities. Chronic pain affects approximately 100 million American adults, with almost half of those impaired in their work or life daily. Because chronic pain is often is often not associated with another condition, it's important to ensure that your medical team includes a doctor that understands the challenges of non-specific pain and alternatives for treatment.
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 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?
You can also use one of several scales to help you identify levels of pain.
Numerical Scale: The most commonly used scale, where pain is ranked from 0 (no pain) to 10 (worst pain possible)
Visual Faces Scale: This format involves showing a number of 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 were 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 you have pain, how bad it is perceived to be, and how much it's impacting your daily life is helpful both to aid in knowing how to assist you, but also as an aggregated set of information to relay to your medical team.
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.
**Information in this article is not a substitute for medical advice. Always consult your medical professional before starting or modifying treatments/medications.