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The experience of pain is unique to each person and influenced by many factors, including the patient’s prior experiences with pain, meaning given to the pain, emotional stresses, and family and cultural influences. Pain is a subjective and multi-faceted phenomenon, and clinicians cannot reliably detect its existence or quantify its severity without asking the patient directly. A brief means of assessing pain and evaluating the effectiveness of analgesia is to ask the patient to rate the degree of pain along a numeric or visual pain scale (Table 5–6), assessing trends over time. Clinicians should ask about the nature, severity, timing, location, quality, and aggravating and relieving factors of the pain.

Table 5–6.Pain assessment scales.

General guidelines for diagnosis and management of pain are recommended for the treatment of all patients with pain but clinicians must comprehend that such guidelines may not be suited for every individual. Because of pain’s complexity, it is important to understand benefits and risks of treatment with growing evidence for each patient (eTable 5–1). Distinguishing between nociceptive (somatic or visceral) and neuropathic pain is essential to proper management.

eTable 5–1.Recommended clinical approach to pain management.

In addition, while clinicians ...

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