Pain management

Ø  Pain is best defined as an uncomfortable or unpleasant feeling that tells you something may be
wrong in your body. It's one way your body sends a warning to your brain. The spinal cord and
nerves serve as passageways through which pain messages travel to and from your brain and the other
parts of your body.

Ø   acute pain

Ø   Pain that occurs immediately after illness or injury and resolves after healing.



Ø   chronic pain

Ø   Pain that persists beyond the time of normal healing and can last from a few months to many
years. Can result from disease, such as arthritis, or from an injury or surgery. Also can occur
without a known injury or disease.

                                         Pain measurements

Ø   Visual. Visual scales have pictures of human anatomy to help patients explain where your pain
is located. A popular visual scale — the Wong-Baker Faces Pain Rating Scale — features facial
expressions to help patients show the doctor how the pain makes his/her feel. This scale is
particularly useful for children, who sometimes don't have the vocabulary to explain how they feel.

Ø   Verbal. Verbal scales contain commonly used words such as "low," "mild" or "excruciating" to
help patients describe the intensity or severity of his/her discomfort. Verbal scales are useful
because the terminology is relative, and you must focus on the most characteristic quality of your
pain.

Ø   Numerical. Numerical scales help patients to quantify his/her pain using numbers, sometimes in
combination with words.



                              The Wong-Baker Faces Pain Rating Scale



Ø   Face 0 is very happy because he

                  or she doesn't hurt at all.



Ø   Face 1 hurts just a little bit.



Ø   Face 2 hurts a little more.



Ø   Face 3 hurts even more.



Ø   Face 4 hurts a whole lot.



Ø   Face 5 hurts as much as you can

                  imagine, although you

                  don't have to be crying to

                  feel this bad.



                                            Faces scale
                                      from Kuttner and LePage
                                              (1989)

                                        A Verbal Pain Scale

     With a verbal scale, you can describe the degree of patients discomfort by choosing one of the
vertical lines that most corresponds to the intensity of pain you are feeling. This is a good way
to explain early postoperative pain, which is expected to diminish over time. You can use this
scale to determine if patient recovery is progressing in a positive direction.

                                      A Numerical Pain Scale

Ø  A numerical pain scale allows you to describe the intensity of patients discomfort in numbers
ranging from 0 to 10 (or greater, depending on the scale). Rating the intensity of sensation is one
way of helping determine treatment.

                                     McGill Pain Questionaire