How is Chronic Pain Assessed?

Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE, discusses assessment of chronic pain.

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Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE, discusses assessment of chronic pain.
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Featuring Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE

Duration: 1 minute, 55 seconds

When we assess chronic pain, we have to assess the different domains of pain.

Let me give you an example of that. When you have pain, if you were to burn your finger, the first thing you would do is pull away, but the second thing you do is swear. The reason you swear is because there's an emotional component to pain.  

The theory is there's an emotional component so that you remember pain, and that's what makes it protective. If you don't remember what hurts you, then it's not helpful.  

Whenever you have a pain experience, you have both the intensity of the pain, the emotional component to the pain – how much does it bother you? – and the cognitive component – what does it mean? – so that somebody who's had a history of cancer who gets back pain may feel that pain a lot more because they're worried it means the cancer is coming back.  

On the other hand, somebody who has stubbed their toe to the point that it's bleeding, but who is walking up the stairs to get their Lotto 649 cheque, may not actually pause to notice their pain.

On another day, when it's been the worst day of their life and everything bad has happened and then you stub your toe, it feels much more intense even though the injury might have been the same.  

The first step to getting assessed for chronic pain is to have somebody assess the area that's painful and determine all of the underlying factors. For instance, in a patient who's had whiplash pain after a car accident, we may look at pain generators in the neck, so we'll look at muscles, ligaments, tendons, and joints and decide what's playing a role in that.

That may involve help or assessment through a physiotherapist, a massage therapist, the physician. It may involve x-rays or a consultation with another specialist.

Presenter: Dr. Pamela Squire, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.