Pain Assessment

Original Editor - The PPA Project

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1. Recognize the differences between acute and chronic pain and the implications for assessment and management of the patient.
2. Emphasize performance of a comprehensive assessment using reliable and validated tools in the acute pain phase to prevent the onset of chronicity.
3. Use a biopsychosocial approach for assessment of pain and disability as it accounts for the multidimensional nature of pain in domains relevant to physical therapy practice.
4. Account for the multidimensional nature of pain by including appropriate assessment measures for primary domains including:
   • Sensory
   • Affective
   • Cognitive
   • Physiological
   • Behavioral
5. Recognize strengths and limitations of commonly used measures for different pain dimensions:
   • Self-report measures as "accepted standard" not gold standard
   • Physical performance measures including Functional Capacity Evaluations (FCEs)
   • Physiological/autonomic response measures 
6. Modify pain assessment strategies to match inherent variability associated with the patient's clinical presentation:
   • Individual factors (e.g. age, sex, etc.)
   • Sociocultural influences (e.g. spirituality, ethnicity, etc.)
   • Clinical characteristics of pain (e.g. duration, anatomical location, etc.)
   • Pain type and state (e.g. neuropathic pain, cancer pain, etc.)
   • Vulnerable populations (e.g. communication barriers, cognitive impairment etc.)
7. Interpret, critically appraise (reliability, validity, and responsiveness), and implement available pain assessment instruments for:
   • Screening for the development of chronic conditions
   • Identifying accepted patient subgroups for application of treatment
   • Determining clinical relevance and/or magnitude of patient outcomes
8. Understand the need to monitor and review the effectiveness of treatment/management and modify treatment and management strategies appropriately.
9. Understand the need to refer to relevant health professional as appropriate and in a timely manner.

References

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