Principles of Pain Management

    1. Ask patients about the presence of pain.

    2. Believe the patient's report of pain. A patient's self-report is the single most reliable indicator of pain. Take pain seriously even when you do not know its cause. Autonomic or behavioral signs of pain may be helpful when present, but are often absent.

    3. Assess the pain including:

      · location, quality, intensity (patient's self report using rating scale; [e.g., 0-10, mild-moderate- severe]), temporal characteristics, what makes the pain better or worse, how the pain affects function and quality of life

      · response to prior and present analgesic medications and non-pharmacologic interventions.

    4. Perform a complete physical exam.

    5. Treat the pain while completing the diagnostic evaluation.

    6. If possible, determine the cause of the pain (e.g., nerve damage, tumor extension, obstruction, etc.)

    7. Institute diagnosis-specific therapy.

    8. Discuss with the patient realistic goals and limitations of pain therapy for the specific pain diagnosis.

    9. Reassess, re-examine, and re-adjust therapy frequently until pain is relieved.

Reprinted with permission: Third Edition: Pain Patient Care Team, September 1996 copyright University of Wisconsin Board of Regents