Chronic pain is one of the common reasons for medical consultation. It is of complex natural history, unclear etiology and poor response to treatment. It causes significant morbidity, suffering, disability and over utilization of health care systems. CPS is a poorly defined condition. Most authors consider ongoing pain lasting longer than 6 months as diagnostic, and others have used 3 months as the minimum criterion. In chronic pain, the duration parameter is used arbitrarily. Some authors suggest that any pain that persists longer than the reasonable expected healing time for the involved tissues should be considered chronic pain. Several factors have been identified as having potential influence on patient’s perception of pain. These include …show more content…
A comprehensive pain history is important in understanding the patient’s problem situation and planning management,
The important elements of pain history
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Aggravating and alleviating factors: What factors aggravate the pain?
What brings about relief or attenuation of pain?
Associated features: What other symptoms are associated with the pain?
How does it affect your sleep? Your appetite? Your energy level?
Treatment history: What are the types of treatment obtained? What was the response? Any side effects with treatment? Investigations?
2. Associated dysfunction
Social dysfunction: Does the pain interfere in social functioning? Has the patient been avoiding social gatherings due to pain?
Activities of daily living: Does the pain interfere with activities of daily living like bathing, dressing etc.?
Occupation dysfunction: has the pain resulted loss of work? Absenteeism? Reduced efficiency at work?
Marital dysfunction: Has the pain affected your relationship with spouse?
Sexual dysfunction: Has there been any sexual dysfunction?
3. Psychological factors.
Chronic pain has high rates of psychiatric comorbidity. Chronic pain is associated with a number of psychiatric conditions. In many pain is the main presenting complaint. It has found to be the main presenting symptom in 45-60% of