One of the most difficult things about chronic pain is that only the patient knows how intense the pain is. There is no blood test to show how great the suffering is. Often, no outward sign such as a bandage is present. Pain is a personal problem. This is invisible to the others and can lead to misunderstanding and even mistrust in relationships.
Whether you suffer from back pain, headaches or other pain, others may not perceive nor understand it easily. To keep the chronic pain under control is not enough to tell your doctor that it hurts. You must learn to talk about the pain, about how to assess pain intensity, how it affects you and what type it could be.
What is the scale that assesses pain intensity?
People experience pain in different ways. Some people suffer from conditions among which symptoms include intense pain, but tolerate quite well. Others have no sign of any physical problems, but complain of increased pain. The level of chronic pain cannot be measured by any screening test or other investigation.
To offset this problem, many physicians rely on scales that are designed to assess pain intensity in order to try to establish more precisely how sharp is the pain of a person. This system of measurement is very important for people who may have communication problems. These include especially children and some people with cognitive impairments.
One of the problems of using this type of measurement is that pain is perceived subjectively. A person with a high tolerance to pain could assess their pain to a 2, while another with the same kind of pain, but with a lower tolerance could assess it to a 6.
Therefore, it was found that the pain is not enough to be given a simple grade, but must be put in a context when quantified. For this purpose, experts ask people to remember the most intense pain they have ever experienced in their lives, whether it’s pain triggered by a kidney stone or childbirth. Compared with this kind of pain, they can provide a more realistic rating of the chronic pain intensity.
How can chronic pain be described?
The doctor must know not only how intense is the pain, but its type. A certain kind of pain can be a particular cause. If the pain is caused by injury of the tissue (such as arthritis or injuries to the back) it will be a dull ache.
However, the pain caused by nerve damage as a result of various conditions (diabetes, carpal tunnel syndrome, etc.) is sharp as a burning or electrical pain. Pain resulting from nerve damage is associated with other non-painful sensations such as tingling or numbness.
Equally important is that the patient notifies the doctor if there are variations in pain or if its fluctuations occur during the day or night, if there are factors that increase pain and situations or things that improve. The more information they provide to the pain specialist, the more likely they will prescribe an appropriate treatment for pain relief.
How can chronic pain affect you?
Besides the severity and type of chronic pain it is important for the doctor to know how chronic pain will affect your life. When a person enters a doctor’s office complaining of chronic pain, most doctors focus on the cause of pain. However, the physician must focus on the symptoms that caused the patient to come to consult: the pain.
Experts believe that there are some important issues that should not be overlooked by doctors. Among the questions that the physician should ask them are:
• Does the pain wake you up during the night?
• Did the pain make you change your habits?
• Does the pain prevent you from moving?
• Does the pain affect your performance at work?
The specific way in which chronic pain can affect your life and change behavior is quite important. This helps the doctor to understand how great the pain is and determine if it is a problem that needs immediate treatment.
Often, chronic pain is accompanied by other symptoms and conditions. It is possible that the patient might be needing treatment not only for pain relief but also for its underlying cause and for other secondary problems that might develop as a result of pain: sleep problems, depression, anxiety or secondary pain.
Chronic pain can be treated, often only by administrating a drug. To control pain often requires the intervention of several experts, a team of doctors should work together (physiotherapist, psychologist, psychiatrist and so on). The patient should be the most important member of this team. Even if physicians are those who provide treatment for chronic pain, he is able to determine how well the treatment works. Also, the patient must assume an active role to talk openly with the physicians about chronic pain and how it affects their lifestyle.