Adult pain assessment and management

One of the most common patient problems health professionals will encounter is pain. Although this is universally experienced, effective assessment and management is sometimes difficult to achieve, as pain is extremely complex. Therefore, when a patient states they are in pain, it is every health professional's duty to listen to and believe what they say, observe for supporting information using appropriate and varied assessment approaches, and act as soon as possible using suitable management strategies.

The holistic assessment and management of pain is important, as pain involves the mind as well as the body, and is activated by a variety of stimuli, including biological, physical and psychological (Cook et al, 2021). For some patients, the pain they experience can be short-lived and easy to treat, but for others, it can cause significant issues to their overall health and wellbeing (Flasar and Perry, 2021).

Mismanaged pain can affect an individual's:

• mobility

Pain classification

It is necessary to have a general understanding of the various types of pain that can be experienced, as well as how these can manifest. This understanding is the first step of the assessment process and will ultimately help to inform management decisions (Cook et al, 2021).

There are several classifications of pain (Table 1), some overlap and patients may present with one or more. Pain can be:

• Acute: pain that takes place over a short duration (less than 3 months) and is reversible
• Chronic: pain that is persistent and has been experienced for more than 3 months
• Nociceptive: pain resulting from stimulation of pain receptors by heat, cold, stretching, vibration or chemicals
• Neuropathic: pain related to sensory abnormalities that can result from damage to the nerves (nerve infection) or neurological dysfunction (a disease in the somatosensory nervous system)
• Inflammation: stimulation of nociceptive processes by chemicals released as

Management strategies

The primary goal for all patients is to pre-empt and prevent pain from occurring in the first instance. However, if pain cannot be avoided, optimal analgesic management is vital.

Analgesia - ‘to be without feeling of pain’ - relates to medication and alternative interventions that provide pain relief (Laws and Rudall, 2013). Hence, pain management plans should incorporate a multi-modal approach in order to successfully and holistically treat patients' pain (Flasar and Perry, 2021). Although this is an effective way to manage pain, the decisions about which management strategies to use must also consider the context of the clinical situation, the patient's level of acuity, the environment and physical space, and the availability of resources (Cook et al, 2021).