During day two at PAINWeek, I attended a lecture event titled “Coordinating Evidence-Based Care for Chronic Pain: Multimodal Therapies for a Multidimensional Disease.” As medicine has evolved, practitioners’ perception of chronic pain has changed. We have come to understand chronic pain as a disease, which is multidimensional in nature. This means that there are generally many factors that contribute to the disease, and often the treatment of pain cannot occur as an isolated event. This lecture sought to explain how to best diagnosis this disease, and to emphasize that just as one patient is not like any other, customized treatment plans must be used to treat each unique case.
In order to understand chronic pain, your physician must start first by diagnosing your condition(s). Unfortunately, the common misconception is that back pain, for example, is a condition. In fact, back pain is a symptom of a disease, and not a disease in itself. There is always an underlying medical condition causing the pain, and only a detailed evaluation of the patient’s medical history along with a comprehensive physical examination must be performed in order to determine the cause of the pain.
The presenters in this lecture suggested using the PQRST model to assess chronic pain in a patient. The model is broken down as follows:
- Palliative or precipitating factors – what are elements that cause or contribute to the pain?
- Quality of Pain – what type of pain is being experienced?
- Region or radiation of pain – where does the pain originate and travel?
- Severity – what is the intensity of the pain?
- Temporal nature of pain – does the pain happen occasionally or is it constant?
The main goals of using a comprehensive assessment strategy are to rule out potentially serious conditions and various specific causes that may be related to your pain symptoms, as well as any neurological disorders. The results of an accurate and detailed assessment will enable your physician to formulate a diagnosis and determine the exact cause of pain so that a multimodal treatment plan can be implemented.
Next time you are visiting your physician, consider how you would answer the questions in the PQRST assessment so that you can provide your doctor with the information they need to accurately diagnose your chronic pain. As always, you should ask your physician if they are recommending the best procedures, therapies and tools you need to manage your pain in the most effective way. PMIR believes in continually furthering your education on advancements in pain management, and helps you stay up-to-date on new procedures, therapies and treatment techniques in order to provide the best patient care possible. Pain can stop you in your tracks. Let PMIR improve your life through pain relief.
Chart Source: PainClinician.com