Acute Medicine | Palliative care | Assessment of pain

Assessment of pain
Session overview
Description
This session gives a framework of how to assess pain as an essential first step to appropriate pain management.

This session was reviewed by Jo Elverson and last updated in September 2022.

Learning objectives
By the end of this session you will be able to:

• define pain, encompassing the physical experience and other factors such as the impact of pain on the patient
• describe the pathophysiology that underlies the different types of pain
• identify the core steps involved in a pain assessment, to reach a diagnosis and initiate a management plan
• list examples of standardised pain assessment tools used in clinical practise and research, and their value
• describe how pain could be assessed in patients with cognitive impairment

We have all experienced pain. It is a personal, individual experience that can be difficult to describe but may be distressing and significantly affects our life, including our mood and how we go about our daily life.

A thorough, patient-centred assessment of pain is a vital part of its management. It allows us to identify reversible causes, consider appropriate treatment options, negotiate an acceptable management plan with the patient and address the psychological, social and functional issues that may be a consequence of pain.

The purpose of a pain assessment is to identify the type and cause of pain experienced by the patient. This will facilitate decision making about an appropriate pain management plan.

Such an assessment will include consideration of:

• factors specific to the pain, for example the onset, severity, location as well as aggravating and relieving factors
• the impact of the pain on the patient's life
• the type and cause of pain being experienced
• a full detailed patient history including current and previous diagnoses, medication use and any other additional information that may be relevant to the onset of pain