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Assessment of patients with chronic pain
Open accessAbstract
Chronic pain is a public health concern affecting 20-30% of the population of Western countries. Although there have been many scientific advances in the understanding of the neurophysiology of pain, precisely assessing and diagnosing a patient's chronic pain problem is not straightforward or well-defined. How chronic pain is conceptualized influences how pain is evaluated and the factors considered when making a chronic pain diagnosis. There is no one-to-one relationship between the amount or type of organic pathology and pain intensity, but instead, the chronic pain experience is shaped by a myriad of biomedical, psychosocial (e.g. patients' beliefs, expectations, and mood), and behavioural factors (e.g. context, responses by significant others). Assessing each of these three domains through a comprehensive evaluation of the person with chronic pain is essential for treatment decisions and to facilitate optimal outcomes. This evaluation should include a thorough patient history and medical evaluation and a brief screening interview where the patient's behaviour can be observed. Further assessment to address questions identified during the initial evaluation will guide decisions as to what additional assessments, if any, may be appropriate. Standardized self-reported instruments to evaluate the patient's pain intensity, functional abilities, beliefs and expectations, and emotional distress are available, and can be administered by the physician, or a referral for in depth evaluation can be made to assist in treatment planning.
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“Chronic pain is complex and taxing to live with, and how patients perceive and relate to pain is based on an interplay of biomedical, psychosocial, behavioral, and cultural factors [1].”
From Digital Self-Management in Support of Patients Living With Chronic Pain: Feasibility Pilot Study (2020) · cites this paper as [1]
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“Chronic pain conditions are often multifaceted and difficult to manage, involving physiological and psychological and social challenges for those affected [1-4].”
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Metadata
- Authors
- Dansie, E. J., & Turk, D. C.
- Affiliations
- University of Washington (US)
- Corresponding author
- Turk, D.C.
- Venue
- British Journal of Anaesthesia
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 111
- Issue
- 1
- Pages
- 19-25
- ISSN
- 0007-0912 (ISSN-L)
- PMC
- PMC3841375
- OpenAlex
- W2086511861
- Cited by
- 409
- References
- 64
- Citations by year
- 2026: 13 · 2025: 26 · 2024: 36 · 2023: 43 · 2022: 32 · 2021: 50 · 2020: 96 · 2019: 36 · 2018: 15 · 2017: 25 · 2016: 18 · 2015: 9 · 2014: 6 · 2013: 2
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- British Journal of Anaesthesia (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R01AR059102-01A, R01AR059102)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pain, pain assessment, pain diagnosis, psychosocial factors, pain intensity, functional capacity, emotional distress, medical history, screening interview, treatment planning
- MeSH terms
- Activities of Daily Living, Humans, Interviews as Topic, Pain Measurement, Self Report, Chronic Pain
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