TY - CHAP M1 - Book, Section TI - Evaluating the Patient with Chronic Pain A1 - Goodwin, Jeremy A1 - Najib, Umer A1 - Bajwa, Zahid H. A2 - Bajwa, Zahid H. A2 - Wootton, R. Joshua A2 - Warfield, Carol A. Y1 - 2016 N1 - T2 - Principles and Practice of Pain Medicine, 3e AB - Pain is a complex multidimensional symptom. It is determined not only by actual or potential tissue injury and normal and abnormal activity of the nervous system, but also by the patient's personal beliefs, mood, previous painful experiences, psychosocial stressors, coping mechanisms, and motivational factors. Evaluation of a patient with chronic pain should take into consideration all of these factors. Unfortunately, there is no single test or scale that can measure pain comprehensively, reliably, or objectively. A thorough history and physical examination, in combination with other diagnostic tools, are critical in the evaluation of pain patients to identify anatomic and physiologic pain generators. Several visits may be required to elucidate relevant medical and pyschosocial factors. The patient's motivation for the evaluation must be clarified early (i.e., whether there are issues of litigation or disability affecting the patient's pain and whether the patient perceives the potential to control pain as coming from within or without). To do this, it is important to listen well, develop the patient's trust, and not overly structure the interview. Chronic pain patients need validation. Without it, they cannot offer their trust, and trust is vital for treatment compliance and a successful outcome. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/11/06 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1131930732 ER -