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Pain Assessment :
The Critical Mandatory First Step
for Effective Chronic Pain Treatment

What is it?

The Pain Assessment is a process of gathering and evaluating information that is needed in order to properly treat any kind of Chronic Pain Condition. Without it, one can only guess and make assumptions at what the appropriate Chronic Pain Treatment Plan for a patient should be.

Is it the same as a Diagnosis?

An Assessment is not the same thing as a Diagnosis. A diagnosis is made by a Doctor and is used to specifically identify an illness, disease, or medical condition. An assessment is a compilation of information that is gathered and evaluated in order to derive an appropriate plan of treatment.

Is the same Assessment used for all parts of the Body?

The same type of assessment is not used for all parts of the human body. A Lower Back Pain Assessment is not the same as a Shoulder Pain Assessment or a Elbow Pain Assessment, but a Fibromyalgia Pain Assessment can consist of all of the above.

What kind of information is included in the Assessment?

The assessment information that is used to develop a treatment plan includes the patient’s Pain Scale, their medical history, an objective observation of symptoms, biomechanical (analysis of body motion and movement) testing, and palpation (analyzing soft tissue by feel).

What is a Pain Scale?

The Pain Scale is defined as the amount of pain that a person is experiencing in a specific part of the person’s body on a scale of 0 to 10, where zero is no pain, and 10 is un bearable pain. 1-4= functional, 5-7=extreme discomfort and difficulty with functionality, 8-9=pain so great that the person is bed-ridden. As part of the Assessment, the patient is given pictures of the human body and is asked to list the specific pain levels on the pictures that give the representation of the patient’s pain.

Pain Scale

Why is Medical History so important?

It is very important for the patient to reveal their medical history because it helps the health practitioner to better understand the historical factors effecting a person’s pain, such as the medications that the person is taking, the time of day when the pain is at its worst, what forms of treatment has helped the patient, and what forms of treatment have not helped the patient.

How does Observation help the Assessment?

Observation of a patient’s symptoms may involve a Postural Analysis, to determine if a patient has good posture or bad posture as a possible source of their pain and will help to improve posture where improvement can be made. An externally rotated foot can indicate a leg length difference that could have a factor on Lower Back Pain. Forward Shoulder rotation can reveal posterior Shoulder Pain as well as Thoracic Back Pain. A Gait Analysis can reveal a limp or favoritism of a limb.

Postural Analysis

What is Biomechanical Testing?

Biomechanical Testing involves the analysis of body motion and movement within identifiable specific planes of that motion and movement. This could involve AROM-Active Range of Motion, PROM-Passive range of Motion, Resistive and other special tests that could possibly help to uncover the source of a person’s pain.

What is Palpation?

Palpation- analyzing soft tissue by feel is an important part of the information gathering process. Texture, temperature, and tone are important factors that let the practitioner know the health of the soft tissues that are involved with a person’s chronic pain. The Joint Mobility Test is a critically important diagnostic Palpation test that is used to determine whether or not the spinal column is a chronic pain syndrome contributor.

How does an Assessment affect the Treatment Plan?

An organized Pain Assessment is the first critical and mandatory step in systematically developing a divide and conquer treatment strategy for the reduction and possible elimination of what once was an overwhelmingly frustrating beast of burden. It is one of the factors that determines the ability and skill of clinical massage therapists to provide patients with new hope, strategies and tactics in the battle against chronic pain.



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