PAIN MANAGEMENT TOOLS: Guide to Chronic Pain Management & Assessment Tools

Pain management tools
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Every now and then, people go through pain, and while some of these are chronic, others are mild. However, pain has a way of affecting our productivity and our overall well-being. That’s the primary reason why we must visit experts to assess the causes of these pains using pain management tools before they become chronic. Healthcare professionals such as nurses or physiotherapists can better understand and communicate with you about your pain by using pain management tools like scales. A precise and methodical pain evaluation is necessary to make the right diagnosis and choose the most effective course of treatment. They are beneficial since pain can vary widely in severity and nature and is experienced differently by various people.

Pain Management Tools

Healthcare professionals can better understand and communicate with you about your pain by using pain scales. They are beneficial since pain can vary widely in severity and nature and is experienced differently by various people (e.g., aching, stabbing, squeezing, etc.) Having a way to gauge your pain is beneficial for:

  • The process of diagnosis
  • monitoring the development of a condition
  • evaluating the performance of a treatment

There are several different kinds of pain scales in use, and each has advantages.

Different Pain Scales

There are at least 11 different types of pain scales available to medical professionals. Typically, they fit into one of three groups:

  1. Numerical Rating Scales (NRS): Using numbers, rate your discomfort using numerical rating scales (NRS).
  2. Visual Analog Scales (VAS): Request that you choose the image that most accurately depicts your level of pain.
  3. Categorical Scales: Use words, maybe in combination with numbers, colors, or places on the body, on categorical scales.

No single pain scale is more ideal or superior to others in every circumstance. However, there are pain management tools that suit a particular age group better. There are also some that better suit people who take a significant role in their own healthcare.

Assessment Tools 

Questioning, measurement, and interpretation skills will help in assessing the degree, severity, and impact of the pain on the patient’s welfare and quality of life, even though crucial observations and behavioral manifestations may indicate that a patient is in pain. The use of specially created tools, which serve as prompts for medical experts and ease the assessment of one or more parameters, can aid this process.

#1. One-dimensional or Unidimensional tool

A verbal rating scale (VRS), numerical rating scale (NRS), or visual analogue scale (VAS) can be used quickly, simply, and repeatedly without the need for sophisticated vocabulary. These are constrained in the knowledge they provide because effective and comprehensive pain management requires looking at more than one particular element. However, unidimensional tools, like the Wong-Baker FACES tool, can be very helpful for those who are unable to communicate or in situations where there are language issues.

#2. Multidimensional tools

These elicit more details and use affective, evaluative, and sensory methods to gauge the severity of the pain. One illustration is the McGill Pain Questionnaire (MPQ). This time-tested method is frequently used to evaluate people who have chronic pain. Another multidimensional instrument that has been shown to be useful for evaluating pain in older people who are unable to express their demands is the Abbey pain scale.

#3. Mnemonics

Mnemonic aids, such as OPQRST and SOCRATES, can be helpful and don’t need any special equipment because they rely solely on mental evaluation processes. For onset, provokes, quality, radiates, severity, and time, use the acronym OPQRST. Site, onset, character, radiates, associations, timing, exacerbating factors, and severity are the acronyms for SOCRATES.

Pain Management Tools for Nurses

Nursing practice must include both assessing and treating pain. They also deal with patients and must have pain assessment tools for assessment. Diagnosis and evaluation of the pain are the initial steps in its therapy; therefore, effective pain management requires a valid pain assessment tool. A tool like this can aid in accurate decision-making during pain treatment and encourage the diagnosis and evaluation of pain. As a result, the method for recording should include a reliable pain evaluation scale. Each hospital should have a practical strategy for pain measurement because evaluation is a fundamental element in nursing care and it can serve as the basis for nursing actions. You can assess the level of pain and the behaviors that go along with it using a variety of pain measuring methods, such as the Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Verbal Descriptor Scale (VDS), Smiling Face Scale (SFS), and Numeric Descriptor Scale (NDS). Let’s look at them individually:

Examples of Pain Management Tools For Nurses

Nurses assess patients’ pain using some of the following pain management tools;

#1. Visual Analogue Scale

The first on our list of pain management tools for nurses is the visual analog scale. It’s the most widely used verified tool. The 10 cm line with descriptive text at either end is the vertical and horizontal VAS. The spectrum goes from no pain to the most excruciating anguish. Patients mark the line to indicate how much pain they are experiencing. The vertical VAS was simpler for elderly patients to use. Whether it is movement pain during rest, the directions must be clear in order to obtain the correct measurement point. Adults’ ratio scale measures of pain intensity are provided by the mechanical VAS (which has a numerical scale on the back).

#2. Numerical Rating Scale (NRS)

The Numerical Rating Scale (NRS) is second on our list of pain management tools for nurses. This is a well-liked unidimensional measure for evaluating acute pain. Here, the patient selects one number from a range of numbers that best describes their level of pain. 

#3. Adjective Descriptor Scale (ADS) or Verbal Descriptor Scale (VDS)

The last on our list of pain management tools for nurses is the Adjective Descriptor Scale (ADS) or Verbal Descriptor Scale (VDS). It consists of phrases that have been carefully picked and ordered to depict how pain becomes more and more intense. Here, the patient selects the word or phrase that best reflects their level of discomfort.

Pain Management Tools for Patients

In dealing with patients’ pains, experts use pain management tools to determine the causes of these discomforts. A pain scale is a graph that shows various degrees of discomfort, from light to severe. Scales for measuring pain can be used by individuals to describe their level of discomfort. Although there are numerous pain scales, one of the following four is frequently employed by medical practitioners and researchers:

  • Numerical scales: Measures pain on a scale of 1 to 10.
  • Visual analog scale: Divides pain into categories along a horizontal axis, from light to severe.
  • Faces Pain Scale: The Faces Pain Scale Revised (FPS-R) represents various pain levels with a horizontal line and facial emotions.
  • Verbal Rating Scale: Here, someone expresses how much pain they are experiencing.

Since these pain scales are unidimensional trusted sources, individuals may express their pain through either words or imagery. Multidimensional pain scales are typically longer and more in-depth to use. It is also important to remember that pain scales do not offer an accurate assessment of pain. Because pain is a subjective experience, what one person may consider to be slight discomfort may be terrible to another.

How Doctors Use Pain Scales

Any form of pain scale can be used by doctors to evaluate a patient’s response to pain. Healthcare providers may take the following into account when choosing which scale to use:

  • Age or reading level of the patient

Children and those with limited literacy may find it simpler to rate their pain on solely visual scales. When evaluating the intensity of adult patients’ pain, healthcare practitioners may decide to utilize a numerical or verbal rating scale.

  • Cognitive ability

Utilizing a faces scale may be simpler for persons who have cognitive difficulties. People who are in shock after an injury, using strong painkillers, or having trouble communicating may find it simpler to understand facial expressions.

  • Depending on a doctor’s area of expertise

Some pain scales may be more helpful than others. For instance, a person working in an emergency room might choose to utilize unidimensional scales since they get results more quickly. To properly comprehend how cancer affects a person’s life, an oncologist may decide to use a multidimensional scale.

Chronic Pain Management Tools

Patients with chronic pain usually undergo more complete and sophisticated evaluations than those with acute pain. The fact that analgesia is simply one aspect of pain management is now well acknowledged. The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials has proposed a list of essential outcome areas for pain clinical trials (IMMPACT). Participants’ personalities, symptoms and negative occurrences, participant ratings of overall improvement, physical and emotional functioning, and pain are some of these factors. Because chronic pain affects all facets of a patient’s life, its diagnosis and treatment should take a multidisciplinary approach. If you want to address the behavioral, cognitive, and emotional aspects of pain treatment, you’ll have to contact a psychiatrist. Complete interdisciplinary care is recommended, and the psychiatrist should be involved in early treatment planning.

Before a psychiatrist evaluates and diagnoses a patient’s pain, there’s a need for a complete review of the patient’s medical history, physical exam, and neurologic examination. During the thorough review, consultants may carry out additional diagnostic tests and assessments. The scales emphasize how important it is to take the patient with chronic pain into account from a number of perspectives. They could serve as suggestions for common clinical procedures. However, they will not take the place of clinical evaluations. Additionally, experts use scales to improve assessments, boost effectiveness, and, perhaps, result in better outcomes.

Types Of Chronic Pain Management Tools

Since chronic pain needs attention before they cause mental disability and affect productivity, there’s a need to manage it before t leads to severe harm using pain management tools. The following are types of chronic pain management tools;

#1. Disability Scales

The first on our list of chronic pain management tools is the disability scale. ADLs are challenging for those with chronic pain. Interference or impairment scales from the Multidimensional Pain Inventory (MPI) and Brief Pain Inventory provide accurate and valid measures of the effects of chronic pain on physical and social function (BPI). These scales provide measurements for all types of chronic pain, as opposed to some scales that are disease-specific. It has been suggested that a change in the MPI interference scale of about 0.6 points and the BPI interference scale of around 1 point serve as a benchmark for clinically significant change.

#2. Emotional Scales

Emotional functioning is a crucial aspect of chronic pain. Mood disorders like sadness, wrath, anxiety, and irritability frequently coexist with chronic pain. The Beck Depression Inventory (BDI) and the Profile of Mood States are both reliable and widely used assessments. Given that many depressive symptoms coincide with chronic pain, determining if there is a distinct depressive disorder may be challenging. You can use a BDI score of at least 21 to distinguish major depression from an understandable reaction to chronic pain.

#3. Global Scale

According to reports, people experience chronic pain in various ways on a daily basis. It’s more difficult to assess general life satisfaction, emotional health, frailty, fatigue, and sleep while dealing with pain. However, you can use a global measure of function to determine a treatment strategy’s overall effectiveness. Generally, if you want to assess a patient’s complete experience with pain, you can use the patient’s overall change scale for it. This one-item measure captures the patient’s personal experience, including improvement in physical and emotional functioning, side effects, convenience, and therapy like pain relief.

What Are the Types of Pain Assessment Tools?

Here are the types of pain assessment 

  • Measures pain on a scale of 1 to 10, numerically. 
  • The visual analog scale divides pain into categories along a horizontal axis, from light to severe.
  • The Faces Pain Scale-Revised (FPS-R) represents various pain levels with a horizontal line and facial emotions.

What Is a Pain Management Tool?

Instruments created to assess pain are known as “pain measuring tools.”

What Is the Best Pain Assessment Tool?

The Iowa Pain Thermometer (IPT), the Numeric Rating Scale (NRS), and the Faces Pain Scale-Revised are the three best options for determining the degree of pain (FPS-R).

What Is the Universal Pain Assessment Tool?

The intensity of pain in individuals with poor communication abilities was evaluated using the Universal Pain Assessment Tool (UPAT).

What Is a 5 on the Pain Scale?

Pain level 5: quite severe. Even though you can’t ignore it for more than a few minutes at a time, you can make an effort to work or engage in some social activities.

What Are the 11 Components of Pain Assessment?

  • Information on the patient’s previous level of functioning
  • Monitoring the patient’s actions while they carry out functional duties
  • The patient’s or family’s description of how pain affects daily activities like work, self-care, exercise, and leisure
  • The patient’s pain management objectives and degree of function
  • The patient’s or family’s account of how pain affects the quality of life
  • Developmental and cultural factors
  • A history of pain in connection with alcohol, drugs, misuse, psychopathology, depression, or other conditions
  • How pain affects a patient’s mental faculties
  • Self-report of pain by the patient
  • Pain-related behaviors and gestures displayed by the patient (e.g. crying, guarding, etc.) factors that affect severity, aggravation, and relief
  • Previous prescriptions

Conclusion

While it’s true that people face pain on a daily basis, we must learn not to allow it to persist by uncovering the causes of those pains using pain management tools. In the long run, it’s generally for our overall well-being. Pains have a way of affecting our productivity, worst still, they can affect our mental health.

Pain Management Tools FAQs

What are the 3 pain scales?

  • Numerical rating scales (NRS)
  • Visual analog scales (VAS)
  • Categorical scales

What is the best pain assessment tool?

The Iowa Pain Thermometer (IPT), the Numeric Rating Scale (NRS), and the Faces Pain Scale-Revised are the finest tools for determining pain severity (FPS-R).

References 

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