Assessing Pain

Pain is hard to talk about. It’s a very personal experience, so it’s little wonder it is sometimes hard for another person to understand exactly what someone with pain is going through. Describing pain intensity is a good example of this. There’s good evidence that highlights GPs find it very hard to accurately assess this; the more severe the pain, generally, the wider they are of the mark. If GPs, who are highly trained doctors & skilled communicators struggle, then it’s little wonder others can too.

To try and get round this, over the years many researchers have designed & published questionnaires to try and add to our clinical assessment of pain. These questionnaires are often called ‘tools’ and are usually rigorously tested & validated before being released for use. Sitting down & talking to a clinician is called ‘subjective’ assessment; filling in questionnaires is a type of ‘objective’ assessment. Probably the best assessments combine both.

  • Screening tools
  • Measurement tools
  • Pre-screening tools

A screening tool is a type of questionnaire designed to try and find out if someone is likely to have a particular condition or illness. These tools need to be good at not missing the diagnosis (called sensitivity) but also not mistakenly diagnose people who haven’t got the problem (called specificity).

Screening tools are different to measurement tools. Measurement tools look at how good or bad something is (e.g. sleep), and often can be used again & again (repeatability) to review progress.

Before we start please answer the following 2 questions:

During the past two weeks, has it often been too painful to do many of your day-to-day activities?

yes/no

During the past two weeks, has your pain been bad enough to often make you feel worried or low in mood?

yes/no

If you answered yes to either of the two questions you might benefit from focusing more closely on optimising your wellbeing and functionality. There’s good evidence that when pain is complex  it’s smart to look at you as a whole & not just try to reduce the pain. This will improve chances of a good recovery.