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DIAGNOSIS
It isn't always easy to talk about pain. Some people think that complaining about pain is a sign of weakness. Yet studies on gender differences show that women are more likely to complain of pain and seek treatment for it than men.
Often, you can successfully treat your pain yourself with common over-the-counter (OTC) pain-relief medications or by making lifestyle changes, without seeking professional help.
For example, if you smoke, you should quit or ask your health care professional for guidance on how to quit. Smoking makes pain worse. Studies, especially for low back pain, have consistently shown that patients who smoke have a much poorer prognosis, regardless of the treatment offered, than nonsmokers. Also, there is some evidence from pharmacological studies that smoking interferes with the absorption and blood level of various medications, including analgesics.
Once you have attempted to self-treat your pain or tried to make lifestyle changes and these approaches don't relieve your pain or it gets worse, you should seek help from a health care professional. Pain itself is a message that there is something wrong; so don't wait more than a few days or a week to make an appointment. In fact, delaying an evaluation and treatment can make many pain-causing problems worse.
In 1999, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) developed new standards for the assessment and management of pain in hospitals and other health care settings. The American Pain Society has endorsed these standards, which are expected to have a dramatic, positive impact on the estimated more than 120 million Americans who suffer from pain. These evidence-based pain management standards require nearly 18,000 accredited health care facilities to make pain management an integral part of all treatment plans. Health care facilities must:
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recognize the right of patients to appropriate assessment and management of pain
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identify pain in patients during their initial assessment and, where required, during ongoing, periodic reassessments and
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educate patients and their families about pain management.
Pain Management Standards can be viewed online at jcaho.org.
Pain: Talk About It
Finding the right words to express your pain and being able to discuss and describe it, may be the key to getting relief for it. When you are experiencing any kind of pain, it might help to think of the word, "PAIN" to help you clearly communicate to your health care professional the following information:
P=the pattern of the pain
- how it started
- how the pain affects your life, work and leisure time
- what activities make the pain better and what make it worse
- what medications relieve the pain, or don't work
- whether the pain is constant or comes and goes
- how long the pain lasts
A=the area affected by the pain
- location of the pain and/or if it moves or "radiates" (spreads out from a core spot) or stays in the same place
I=the intensity of the pain
- the severity or intensity of the pain (on a scale of 0 to 10, 0 being no pain, 10 being the worst it can be)
- what the pain is like now (what it is like at its worst and at its least)
N=the nature of the pain
- the physical sensation of the pain: stabbing, burning or aching, for example
- how it feels to you and makes you feel: tiring, exhausting, sickening, fearful, vicious
(Source: PAINUCope, a multimedia educational program for people living with pain. ©1998 D. J. Wilkie.)
