Bates’ Visual Guide to Physical Examination

Volume 5: 5.5 Acute and Chronic Pain Video Transcript

Narrator: Many now consider pain the fifth vital sign. Adopt a comprehensive approach to understanding any pain the patient may report, listening carefully to the patient’s description of the many features of pain and its contributing factors. Accept the patient’s self-report, which experts state is the most reliable indicator of pain.

Ask the patient to point to the pain, because patients often cannot describe or localize the site of origin. Ask the patient to describe the pain and how it started and whether it is related to a site of injury, movement or time of day. Identify the seven features of the patient’s pain. Also ask about the quality of the pain: sharp, dull or burning. Ask if the pain radiates or follows a particular pattern. Ask what makes the pain better or worse.

Assessing the severity of pain is especially important, and there are many scales at your disposal to help determine that, which can be used by children as well as patients with language barriers or cognitive impairment. Managing pain is a complex clinical challenge and treatment should be multidimensional. You should strive to attain an in-depth knowledge of analgesics and behavioral and physical therapy as well as the risk factors of possible treatments.