? asked in Science & MathematicsMedicine · 1 decade ago

Why is pain difficult to assess?

What are some objective measures that a health care professional can use to evaluate pain?

Do you think there is a stigma attached to people who use pain medications on a regular basis? Explain your response.

3 Answers

  • 1 decade ago
    Favorite Answer

    There are no lab tests to measure pain. It doesn't show up on any blood tests, and the exact same injury in two different people can result in two completely different pain responses. Pain can only be determined by asking the patient to describe it. We have a saying, "the pain is exactly as the patient describes it, located exactly where he says it hurts, in exactly the intensity he says it is." Is there a stigma attached to people who use regular pain medications? No, not particularly, especially if there is a demonstrable chronic cause for pain. If you just came from the dentist and had three root canals performed, I'm certainly going to believe you when you tell me you're having pain. But if you're still having pain 3 or 4 days later, you need to go back to your dentist. Or if I can clearly see on your EKG that you're having a heart attack, we're going to give you morphine without hesitation, but you won't get it for an undetermined length of time; you need to submit to having the infarct resolved.. Some people have chronic long-term painful conditions (e.g., Osteo Arthritis) that require long-term medications. Most of these patients have long established relationships with one doctor who knows their clinical history, and has their xrays and CT scans on file, and it can be clearly demonstrated that they have a permanent or long-term problem.. But not always; this can be a fuzzy grey area, too. There are non-pharmaceutical treatments for pain that can work in some people, and there are also certain individuals who have learned to practice meditation to control and alter their response to pain. And some pain sufferers simply don't want to take narcotics if it is humanly possible; they just don't like the feeling of being narcotized. The RUB comes with addicts, who come into the hospital and make phony claims of pain to get drugs. Usually their complaints don't match what they're complaining about. In some areas, addicts make the rounds of hospital ER's, seeking drugs, more drugs, ever more drugs. But if you suggest that they make an appointment to consult with a pain control doctor, or get the cause of their pain under control, or you offer to give them non-narcotic medications and they balk at your suggestions, then you have suspicion that they are drug seeking. Over time, you get to know your addicts. If he's coming in with his 5th heart attack in 2 weeks and keeps turning in normal EKG's and he stays alive, you become suspicious. In some major metropolitan areas, hospitals exchange information about who is coming in seeking narcotics, and we keep track of those habitual users. Frequent Fliers, they are called. Or, sometimes we have nurses and technicians who work more than one hospital and recognize a patient this evening as being the same person who was at another hospital 8 hours ago seeking narcotics. It's a cat and mouse game; they play their game and we play ours. It's a shame the addicts ruin it for everybody. It would be so wonderful if you could trust everyone who tells you they are having pain, and simply give them narcotics to control their pain without question. But it just doesn't work that way. We are not drug pushers, and we didn't go to school to become drug dealers. We need to understand where your pain is coming from, are narcotics appropriate, and what you are doing to overcome it before you get handed narcotics. State regulators watch us like hawks, and our licenses are at risk if we simply dole out unlimited narcotics without appropriate cause..

  • donpat
    Lv 7
    1 decade ago

    Pain is real but very difficult to assess. The person feeling the pain is the only one that has

    the actual contact with the pain.

    I have trouble with getting my own pain given proper attention and assessment.

    Some people do attach a stigma of sorts to those that have chronic pain requiring

    pain medication on regular basis.

    Source(s): My own experiences.
  • Anonymous
    1 decade ago

    Vital signs are pretty much the only "objective signs".

    Patients LIE all the time trying to get drugs because they want to either get high or sell the drugs to get $$.

    In the ER we call them drug seekers, and we keep a database of how often ALL patients come in, why, what dates they come in and why, and what prescriptions they got. 9 times of 10, patients who come in with certain specific complaints are faking drug seekers.

    Here are examples I see in the ER every day. In EVERY instance, they are drug seekers looking for either Vicoden or Percocet.

    DENTAL/TOOTH PAIN (any moron knows there are no dentists in the ER)



    ARM or LEG STRAIN (ie arm or leg pain without any specific injury)

    Any ER nurse will tell you that Fibromyalgia is the most abused Bulls*** excuse of a diagnosis known to man. Whiny people who can't cope with life tell their doctor they have pain all the time everywhere, and the doc labels them fibromyalgia, then puts them on pain meds. They get a tolerance to the oral meds, and then need more and more to get their 'fix'. I once had a patient tell me she needed 10mg of Morphine to deal with her "terminal" fibromyalgia!!!!

    Like fibromyalgia can kill you???? Did she actually think that or did she think ER nurses are stupid?

    You say the phrase "I have fibromyalgia" to an ER nurse, you will IMMEDIATELY AND FOREVER be labeled WHINEY, STUPID, and DRUG SEEKING. Because they all ARE that way.

    Whine whine, look at me, I have fibromyalgia, I need drugs.

    It's like that with EVERY patient, and 9/10 of fibro patients are WOMEN.

    Nurses hear that word in the ER, we have to turn around and leave the room as soon as possible, before we accidently laugh in the patients face for being a whiney a** loser.

    What was that you were asking about a stigma????

    Source(s): ER nurse, 14 years.
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