RT Book, Section
A1 Goodwin, Jeremy
A1 Najib, Umer
A1 Bajwa, Zahid H.
A2 Bajwa, Zahid H.
A2 Wootton, R. Joshua
A2 Warfield, Carol A.
SR Print(0)
ID 1131930732
T1 Evaluating the Patient with Chronic Pain
T2 Principles and Practice of Pain Medicine, 3e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071766838
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1131930732
RD 2024/04/18
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.