Among the following components thorough pain assessment, which is the most significant?
A. Effect
B. Cause
C. Causing factors
D. Intensity
Correct Answer: D. Intensity
Intensity is the major indicative of severity of pain and it is important for the evaluation of the treatment. Severity of pain may include the intensity graded by the patient or the impact pain has on function. Intensity may be assessed with certain scales that will be reviewed below. The impact on function may include changes with activities of daily living, activity level, and work-related duties. Pain may have an impact on sleep, mood, appetite, or social relationships.
Option A: The effect of pain is an important factor during assessment, especially on the activities of daily living, but it is not the most significant. Factors that relieve pain should be assessed not only to aid in diagnosis, but also with determining what has been attempted and what helps or does not help with their pain. Determining how the patient alleviates pain may also assess for healthy coping behaviors.
Option B: Various stimuli may exacerbate pain, and determining these factors can aid in establishing the pathophysiologic mechanisms of pain. The history of pain or “pain history” is the physician’s initial tool to assess a patient in pain. A detailed history and physical examination is essential, not only to narrow the diagnoses but also to guide further diagnostic studies, if appropriate.
Option C: Causing factors are not a part of the components in assessing pain. Different disease processes may present with similar pain characteristics. Vascular and neurogenic claudication symptoms are a classic example. However, patients with similar pathology may describe different types of pain or may have no pain at all (eg, spinal cord lesions, diabetic neuropathy).