History
This is the description of the illness, which the doctor will obtain by asking appropriate questions
This is the description of the illness, which the doctor will obtain by asking appropriate questions.
Expect to be asked questions about:
- The onset of the pain
- How long ago did it first start?
- Was there any apparent cause for the pain then?
- Was the start sudden or gradual?
- The severity of the pain
- You may be asked to describe this in words or to use a pain scale.
- Does the severity vary?
- Are there any things that worsen the pain (for example lifting, eating) or that reduce the pain (for example rest, painkillers)?
- The quality of the pain
- You will be asked to describe the pain in words. For example, pain may be sharp (stabbing), dull (aching), burning, like a tight band, etc.
- There may be more than one type of pain, for example a constant dull ache with occasional sharp stabs.
- The site of the pain
- You will be asked to indicate where the pain is, and you may be asked to draw the site of the pain on a picture.
- Sometimes the pain starts in one place and then extends (radiates) somewhere else. An example of this is sciatica, when pain in the back radiates down a leg.
- You may have more than one site of pain. If so, you may be asked which is the most troublesome.
- Timing
- When did the pain start?
- Does the pain
- Remain all the time?
- Appear every now and then?
- Come and go quite frequently (for example migraine)?
- Is the pain worse at a particular?
- Time of the day or night?
- Time in the menstrual cycle (for women)?
- Are there other associated symptoms?
- Associated symptoms will vary according to the site and cause of the pain, but could include a bloating feeling in the abdomen, weakness or numbness in the legs, or alterations in vision. It may also include mood symptoms such as depression. Chronic pain often causes depression, and depression in turn increases the perception of pain.
- How is the pain affecting functioning (housework, employment, social life)?
- The way the pain affects you will vary according to the site of pain, the underlying cause and you as a person. Different people respond differently to their pain, but the effect the pain is having on your life may alter the approach taken to treat it.
For acute pain, and some types of chronic pain, a good history may be enough to give a likely diagnosis and form a treatment plan. Sometimes further investigations will be used.
For chronic pain, other ways of assessing pain may be used. You are more likely to have these forms of assessment used if you are seen in a specialist pain clinic.