Pain is an indicator of disease. It is frequently the reason why someone would present to an hospital.
The way the pain present varies with the disease process ( when the patient is presenting) , the type of organ involved.
It is worth noting to note that pain is subjective. The level of the pain is influnced by various factors which include
- The disease itself
- The perception of the patient about the disease
- The cultural norms about pain . It is seen as weakness in some culture to feel pain.
- Has he lost a relation or family because of similar complaints.
- Was he coerced by family to present
The above factors would affects the level of pain.
Medical science have found ways to quantify pain.
At best pain is better seen as being subjective. Only the person affected can quantify it.
The following section would help in describing the pain.
SITE:
Where is the pain located.?
Is it localized or diffuse
Is it superficial, deep or both.
Pain in the epigastrium may be from the stomach, pancreas, liver,
Pain in the right hypochondrium may be from the liver, gall bladder, colon.
Pain in the flanks / lumbar region may arise from the kidneys, ureters , intestine, colon
Pain in the iliac fossa may be from appendix ( right side) , ureters, colon, ovaries, tubes
Pain in the suprapubic region may be from the bladder, ureters, uterus, ovaries, tubes, colon and rectum.
Some pain are however reffered pain.
The pain is felt at a site distant from the location of the affected organ.
ONSET:
Was the pain sudden or gradual.
Sudden pain can be from injury, rupture of and organ. Sudden blockade to blood supply of an organ.
Gradual pain may be inflammatory, or from a tumor pressing on a nerve.
NATURE OR CHARACTERS
Is it sharp, aching, burning,
Wax and wane., Twisting, crushing.
Throbbing pain which increases with each heart beats.
MODIFICATION
does the pain changes with any habits,
Food make it worse or better
What relieve the pain? Or make the pain worse.
Does the pain moves around.
TlMING
Is the pain on and off?
Any particular time of the day that the pain get severe or better.
If there are relief, is it total relief between episodes or partial relief?
Is the pain now more frequent or persistent..
Any similar pain in the past. Compare current episode with the former.
Any previous treatment? Orthodox, surgeries, medication and the outcomes.
SEVERITY
How bad is this pain. Can you still go to work despite the pain. The pain can be so severe that the individual would not be able to do regular activities.
The severity of pain is subjective. However a rough estimate can be obtained by asking the patient to grade their pain on a scale of 0 to 10.
0 means no pain at all ; 10 being the worst possible pain imaginable.
THE AIM OF THIS DESCRIPTION IS TO HELP THE PHYSICIAN MAKE A PROPER DIAGNOSIS.
Watch out for next episodes