Chapter 10: Pain assessment and management
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Overview
Pain is a symptom that is often experienced by patients seeking healthcare. It can be the presenting symptom that prompts patients to seek medical attention, initiating the first contact with healthcare professionals.
Pain can be experienced suddenly and unexpectedly as a result of acute conditions such as trauma, acute illness or surgery. This is referred to as acute pain.
Pain can also be experienced as a result of longer‐term conditions such as osteoarthritis, rheumatoid arthritis, low back pain and sciatica, headaches or migraines, endometriosis, or irritable bowel syndrome. Pain may also be present in the absence of a diagnosis or identifiable cause. In these conditions, pain is often referred to as chronic, persistent or long term.
Pain is a complex subjective multidimensional experience. Effective assessment and management of pain can relieve suffering and can help to reduce patient anxiety associated with pain. While technological advances in other areas of nursing continue to refine the assessment and management of patients, to assess and manage pain effectively nurses will be required to utilize knowledge, interviewing skills and physical assessment skills due to the subjective nature of pain and pain assessment.
This chapter focuses on definitions of pain, anatomy and physiology related to pain, pain assessment, and pharmacological and non‐pharmacological approaches to pain management. It focuses primarily on acute and chronic pain. For the comprehensive management of cancer pain, see the chapter on pain assessment and management in The Royal Marsden Manual of Cancer Nursing Procedures (Lister et al. [97]).
