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Speak the patient's language: The Language of Pain

PAIN

How the patient describes the pain may help in diagnosing its cause. Myocardial pain is often described as stabbing, but biliary pain as cramping.

Open questions:


  • Which part of your (head, arm, face, chest,...) is affected?
  • Where does it hurt?
  • Where is it sore?
  • Can you describe the pain?
  • What is the pain like?
  • Is your pain severe?
  • Is there anything that makes it better?
  • Does anything make it worse?
  • Does anything relieve the pain?
  • Does lying down help the pain?

 

Describing the characteristics of pain:


Dull pain - pain that is not sharp "She felt a dull ache at the back of her head."

Burning pain - painful in a way that feels hot "Indigestion can produce a burning pain in the middle of the chest."

Gnawing pain - continuously uncomfortable or painful "After three days, we felt a gnawing hunger."

Sharp pain - describing a quick, strong pain that makes you feel like you have been cut. "I have this sharp pain in my chest, doctor."

Stabbing pain - a sudden pain "She was awoken by a sharp stabbing pain in her chest."

LANGUAGE FOR PAIN ASSESSMENTS


ONSET

  • When did the pain start?
  • How long does it last (duration)?
  • How often does it occur (time)?
  • What were you doing when the pain started?

PROVOKING FACTORS

  • What brings it on? = What causes the pain to start
  • What makes it better?
  • What makes it worse?

QUALITY

  • What does it feel like?
  • Can you describe it?
    • Throbbing - pain that is felt as a series of regular beats: "Pain medication had faded his headache to a dull throb." 
    • Stabbing
    • Dull
  • REGION & RADIATION
    • RADIATE to spread out in a direction from a central point. 
      • "Does your pain go anywhere?"
        • "Yes it goes down my arm"
      • The patient's pain radiates down his left arm.
  • SEVERITY
    • "How would you rate your pain on a scale of 1-10 right now." "10 being the worst and 1 being the least"
  • TIME
    • "When did the pain start" 

 

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