Description

Pain is a subjective sensation of discomfort that is best communicated by the person experiencing it, using descriptive words. As caregivers, we will be caring for some people who are able to talk to us. Others we care for will not be able to verbally tell us they are in pain or to describe the type of pain they have. When the people we are caring for are unable to communicate with words, our job as caregivers, is to pay attention to nonverbal signs as pain is the most under reported and under treated symptom. Nonverbal signs may be confusing to interpret. They may be indicative that something is wrong, but not necessarily be specific for pain.

Common nonverbal signs associated with pain

• grimacing
• agitation
• moaning
• resistance to care and movement
• combativeness
• withdrawal
• sweating
• loss of appetite
• increased anxiety
• anger
• change in usual interaction with caregivers

When these signs are present, it is the job of the caregiver to seek medical help.

Anytime you experience pain that does not resolve on it's own, you should seek medical attention to determine the cause. Pain can be minor and of short duration, or can signal a major health issue. Pain can also be chronic and part of the normal aging process. Sometimes pain can not be cured, however it can always be better managed with the help of your physician or medical provider.

Questions

• When did the pain start?
• Is the pain all the time or is it intermittent?
• What makes the pain start and what makes it go away?
• What makes the pain better or worse?
• Where is the pain located?
• Does the pain stay in one spot or does it travel to other spots?
• Is there more than one area that hurts at the same time?
• What words or nonverbal signs would you use to describe the pain?
• What do you think is causing the pain?
• Why do you think the pain is occurring?
• Is this a reoccurring pain? What relieved the pain before?

• What medications (over the counter as well as prescribed) have been tried in an effort to control the pain? How effective are they? If they worked, how long was the relief?
• Are there any non-medicinal factors that decrease the pain such as heat, cold pack, etc?
• Are there any other symptoms associated with this pain?
• Is this pain associated with stress, depression or anxiety?
• What is the intensity of the pain? Using a scale of 0-10 (0 is no pain and 10 is the worst pain), how would you rate this pain?

Important Points to Consider

There are three major categories that pain is divided into. They are neuropathic, somatic and visceral.

• Neuropathic pain is nerve related pain. It is often described as burning, electric shock like sensation, numbing, pins and needles, shooting pain that starts in the back and goes down into the legs. Common causes of neuropathic pain includes: shingles, diabetic neuropathy, and sciatica or back related pains.
• Somatic pain refers to musculoskeletal pain. It is often described as aching, sharp, pressure, teraing, worse with movements, and changing with position or when taking a deep breath. Common causes of somatic pain includes: arthritis, sprains, fractures, muscle tears, pleurisy, burns, torn ligaments, tendonitis, and muscle tension headaches.
• Visceral pain refers to deep organ pain. It is often described as cramping, intermittent bloating, and is often associated with referred pain. Common causes of visceral pain include: constipation, inflamed gallbladder, distended bladder, bowel obstruction, kidney stones, irritable bowel disease, ovarian or any colon cancer.

As you can see the cause of pain can vary from having a minor impact on your general health to a major devastating illness. That is why it is never a good idea to ignore pain that is persistent, recurrent or worsening.

Related topics

Managing Pain