September 25, 2020
How to identify and assess 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 point in our lives. There are a variety of common words to describe pain, such 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.
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 your loved one is in pain, it is important to see if they can determine which type they are experiencing.
Somatic pain: A person feels 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: This pain originates in the internal organs and the linings of cavities in the body. It can indicate a more deeprooted disease or a more serious accident.
Referred pain: A person feels referred 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 not associated with another condition, it’s important to ensure that your loved one’s medical team includes a doctor that understands the challenges of non-specific pain and alternatives for treatment.
PAIN SCALES
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 with your loved one 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 your loved one identify levels of pain.
Numerical scale: The most commonly used scale, where pain is ranked from 0 (no pain) to 10 (worst possible pain).
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 where 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 your senior hurts, how bad they perceive the pain to be, and how much it’s impacting their daily life is helpful both to aid you in knowing how to assist them, but also as an aggregated set of information to relay to their medical team.
Non-Verbal Pain Cues
If your loved one is cognitively impaired, there are still ways to determine that they are in pain. Here are some examples of cues to pay attention to if they are not in their normal state of being.
Restlessness
Crying, moaning, and groaning
Resistance to care
Increased wandering
Sleeping or eating problems
Non-Verbal Pain Cues
If your loved one is cognitively impaired, there are still ways to determine that they are in pain. Here are some examples of cues to pay attention to if they are not in their normal state of being.
Restlessness
Crying, moaning, and groaning
Resistance to care
Increased wandering
Sleeping or eating problems
Source: ClearCare Online
At EPAGA Home Care, our caregivers are thoroughly trained in providing care to seniors and those with disabilities, including making trips to the doctor’s office effortless.
For more information on how we can assist you or your loved one with services like visits to primary care physicians, please visit our services page at the link below.