Pain Assessment  

1. Pain Assessment 

Pain is a subjective experience, but proper assessment is crucial for effective management. The assessment involves evaluating: 

Onset: When did the pain start? Was it sudden or gradual? 
Location: Where is the pain? Does it radiate? 
Duration: How long does it last? Constant or intermittent? 
Character: What does it feel like? (e.g., sharp, dull, burning, throbbing) 
Aggravating/Relieving factors: What makes it worse or better? 
Severity: Usually rated using a pain scale. 
Impact: Effect on sleep, mobility, daily activities, and mood. 

2. Non-Verbal Signs of Pain 

Some patients cannot communicate verbally (e.g., infants, people with dementia, or intubated patients). Observing non-verbal signs is essential: 

Facial Expressions: 
Grimacing 
Frowning 
Lip biting or pursing 
Brow lowering 

Body Movements / Posture: 
Guarding (protecting a body part) 
Restlessness or pacing 
Rocking or rubbing a painful area 
Stiff or rigid posture 

Vocalizations: 
Moaning 
Crying 
Groaning 
Sighing 

Physiological Changes: 
Increased heart rate, blood pressure, or respiration 
Sweating or pallor 
Flushed face 

Behavioral Changes (especially in older adults): 
Withdrawal from social interaction 
Reduced appetite 
Sleep disturbances 
Irritability or aggression 

3. Pain Measurement Tools 
Several tools exist depending on patient age, cognitive status, and communication ability: 


Key point: Choose a tool appropriate for the patient’s communication ability and consistently monitor changes over time. 

4. When to Seek repeat Medical review

Seek medical advice if pain is: 

Sudden and severe or the worst ever experienced 
Accompanied by chest pain, shortness of breath, or neurological symptoms 
Persistent or worsening despite over-the-counter medication 
Associated with fever, swelling, redness, or infection 
Interfering with daily functioning, sleep, or mood 

Red flag situations requiring urgent evaluation: 

Severe abdominal pain with vomiting or bleeding 
Severe headache with vision changes or neurological deficits 
Pain after trauma or surgery that is uncontrolled 

Summary: 

Pain assessment = subjective + observational data. 
Non-verbal cues are essential particularly for those unable to communicate. 
Use validated pain tools tailored to patient needs. 
Seek medical help for severe, sudden, persistent, or worsening pain or when it affects vital functions.