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In addition, it often has an associated autonomic component, such as diaphoresis, capillary vasodilation, hypertension, or tachycardia. Pain etiology By taking a complete history and answering the preceding two questions, the clinician can begin to formulate the causes of the pain.The rest of the history, as well as the physical examination, can be tailored to systematically explore aspects of pain, such as symptoms and physical signs, common to the particular type of pain in question.

The pain history is key to the assessment of pain and includes the patient’s description of pain intensity, quality, location, timing, and duration, as well as ameliorating and exacerbating conditions. Conclusion Selected Reading Pain is a complex multidimensional symptom determined not only by tissue injury and nociception but also by previous pain experience, personal beliefs, effect, motivation, environment, and, at times, pending litigation. Self-report is the most valid measure of the individual experience of pain.The BPI correlates with scores of activity, sleep, and social interactions. Massachusetts General Hospital (MGH) Pain Center pain assessment form The MGH form (Fig.It is cross-cultural and a useful method for clinical studies (Fig. 3) combines many of the preceding assessment instruments and is given to all patients on initial consultations at the MGH Pain Center.It elicits information about pain intensity, its location (via a body diagram), quality of pain, therapies tried, and past and present medications.

It takes 10 to 15 minutes to complete and is an extremely valuable instrument.

Visceral afferent information may converge with superficial afferent input at the spinal level, referring the perception of visceral pain to a distant dermatome.

Visceral pain is diffuse and often poorly localized.

Children as young as 3 years may reliably use this scale. Face 0 is very happy because he doesn’t hurt at all. Mc Gill Pain Questionnaire (MPQ) The MPQ is the most frequently used multidimensional test.

Descriptive words from three major dimensions of pain (sensory, affective, and evaluative) are further subdivided into 20 subclasses, each containing words that represent varying degrees of pain.

Referred pain usually arises from visceral or deep structures and radiates to other areas of the body.