Pain assessment for patients

Modified from the American Pain Foundation

Health care providers use the word assessment to describe questions they ask to learn more about you and your pain. When you come to the facial pain clinic the doctor will ask about your pain and pain relief at each visit: If they do not ask, and you are experiencing pain, tell them. Describe any changes since your last visit. The better you describe the pain, how it affects your life and activities, and what works to relieve it, the easier it will be for others to help.  It may be helpful if you read through this before your appointment with the doctor.

Where does it hurt? Does the pain move from one place to another?

Tell exactly how the pain feels. Does it feel like it’s on the inside your mouth or face ? Or does it seem like it is on the outside? Point to the places that hurt. Show where the pain moves if it travels from one place to another. Use a drawing of the outline of a face to show the places where it hurts. Be sure to show all of the places that hurt, not just the spot that hurts the most.

Do you have more than one spot where it hurts?

You may have more than one kind of pain – some caused by the disease or disorder, some by the treatments, and some unrelated – a stress headache, for instance. It is important to describe each kind of pain in detail.

When does the pain happen? How long does it last? Does the pain come and go? Or is it there all the time? Is this pain new? Have you ever had this pain before? When does it begin? When does it end?

Describing pain this way helps others know more about the pain.

Does the pain keep you from doing all you want to do?

Pain may stop people from moving, eating, working, playing, or getting around. Sometimes pain interferes with thinking and concentration. Pain can interfere with being close to other people. Describing how pain limits your life will help your doctor set goals with you for dealing with your pain.

Does pain interrupt your sleep? Does it change your mood? Affect your appetite?

When pain interferes with sleep, mood, or appetite, it can affect all parts of life. A first goal for treatment is to ensure a good night’s sleep. When you are well rested, you have more energy to try to get well, to talk with others, to enjoy life, and to do the things that are important to you. Pain can also cause you to feel grumpy or sad, especially when it lasts a long time. Pain can change the way you eat and cause you to gain or lose weight. Pain that won’t go away can change the way you feel about yourself and others. Explaining how pain affects you can help others understand more about your pain and how to make it better.

What do you think causes the pain?

Your doctor need to know what you think is happening and causing your pain. Doctors will look for the cause of the pain. But even if the cause is not found, pain can be treated.

What makes the pain better? What makes it worse?

People try things to relieve pain. Some work well; others may not work at all. Sometimes pain occurs when you eat or open your mouth wide. Sometimes staying in one position eases the pain. Telling your doctor about these things can help them control your pain more quickly.

What have you tried to relieve the pain?

Different kinds of pain respond to different treatment. You may already have found things that work well to relieve the pain. You may have tried relaxation, meditation, heat, cold, or mild exercise. These may all relieve some kinds of pain. If so, your doctor will want to include these actions in your treatment plan.

You also might have tried things, such as certain medicines, that did not relieve the pain. Your doctor needs to know this to avoid delays in finding just the right treatment for you.

Your doctor also needs to know all of the over-the-counter medications you take and what medicines have been prescribed for you by another doctor or nurse practitioner. Some medicines can’t be taken together. Some medicines with different names contain the same chemicals and could be harmful if too much is taken.

What medicines are you taking for pain right now?

Describe all the medicines you have tried for pain in the last two or three days. Be prepared to list all other medicines as well. List the name, amount of medicine, time the medicine was taken, amount of relief, and any side effects.

How are you currently taking medications to relieve pain?

Sometimes medications that have not worked before might be effective if they were taken in a different way. Describe exactly how and when you are taking medicines now. Your doctor needs to know if the way you are taking medicine is different from the instructions on the bottle.

Describe how long the medicine takes to work. How long does pain relief last? Does all of the pain go away after you take the medicine? Does the pain return before the next dose is due?

Answers to these questions make it easier to come up with a plan that works for your pain.

Do you have any side effects from medicines you are taking? Do you have any allergies?

Medicines for severe pain tend to cause side effects.  These could include feeling drowsy, unable to walk straight, not being able to think clearly. Talk about other side effects that cause problems some may be avoidable. Discuss your allergies to medicines and other things. Describe how the allergy showed itself and when you first noticed it.

Do you have any worries about taking medicines for pain relief?

Many people worry about taking medicines for pain relief. They worry about addiction and other side effects. Addiction rarely occurs in people taking medicines for the relief of pain. Your doctor needs to know how you feel about this. They should explain that it is not a problem. Ask questions about other worries you may have.

How much relief would allow you to get around better? What is your goal for pain relief? What are your other concerns?

You may be asked to set a goal for pain relief. The goal may be based on the ratings scale (for example, 2 on a scale of 0 to 10). Or, your goal may focus on activities you would like to carry out (eating without pain, being able to work). The aim of the treatment plan is to meet the goals you set for pain relief. You may also want reassurance that the pain is not a sign of something serious.

Tell the doctor a little about yourself, your childhood, work, leisure activities, the people you live with .

The doctor will ask you some questions about your life as it helps the doctor understand how the pain may have arisen and how people around you respond to it. It will also help in trying to set you some goals to work towards.