Diagnosis of Pain

How is Pain Diagnosed?

There is no way to tell accurately how much pain a person has. Tools to measure pain intensity, to show pain through imaging technology, to locate pain precisely, and to assess the effect of pain on someoneís life, offer some insight into how much pain a person has. They do not, however, provide objective measures of pain. Sometimes, as in the case of headaches, physicians find that the best aid to diagnosis is the personís own description of the type, duration, and location of pain. Defining pain as sharp or dull, constant or intermittent, burning or aching may give the best clues to the cause of pain. These descriptions are part of what is called the pain history, taken by the physician during the preliminary examination of a person with pain. Developing a test for assessing pain would be a very useful tool in diagnosing and treating pain.

Physicians, however, do have a number of approaches and technologies they use to find the cause of pain. Primarily these include:

A musculoskeletal and neurological examination in which the physician tests movement, reflexes, sensation, balance, and coordination.

Laboratory tests (e.g. blood, urine, cerebrospinal fluid) can help the physician diagnose infection, cancer, nutritional problems, endocrine abnormalities and other conditions that may cause pain.

Electrodiagnostic procedures include electromyography (EMG), nerve conduction studies, evoked potential (EP) studies, and quantitative sensory testing. These procedures measure the electrical activity of muscles and nerves. They help physicians evaluate muscle symptoms that may result from a disease or an injury to the bodyís nerves or muscles. EMG tests muscle activity. It can help physicians tell which muscles or nerves are affected by weakness or pain. Nerve conduction studies are usually performed along with EMG. These studies record how nerves are functioning. EP studies measure electrical activity in the brain in response to sight, sound, or touch stimulation. Quantitative sensory testing can establish thresholds for sensory perception in individuals which can then be compared to normal values. These tests are used to detect abnormalities in sensory function and nerve disorders.

Imaging, especially magnetic resonance imaging or MRI, provides physicians with pictures of the body's structures and tissues, such as the brain and spinal cord. MRI uses magnetic fields and radio waves to differentiate between healthy and diseased tissue.

X-rays produce pictures of the body's structures, such as bones and joints.

Source: NINDS (NIH)1

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Back to: « Pain

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Describing Pain

Many people have a hard time describing pain. Think about these questions when you explain how the pain feels:

  • Where does it hurt?
  • When did it start? Does the pain come and go?
  • What does it feel like? Is the pain sharp, dull, or burning? Would you use some other word to describe it?
  • Do you have other symptoms?
  • When do you feel the pain? In the morning? In the evening? After eating?
  • Is there anything you do that makes the pain feel better or worse? For example, does using a heating pad or ice pack help? Does changing your position from lying down to sitting up make it better? Have you tried any over-the-counter medications for it?

Your doctor or nurse may ask you to rate your pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine. Or, your doctor may ask if the pain is mild, moderate, or severe. Some doctors or nurses have pictures of faces that show different expressions of pain. You point to the face that shows how you feel.

Source: NIA (NIH)2

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Some people put off going to the doctor because they think pain is just part of aging and nothing can help. This is not true! It is important to see a doctor if you have a new pain. Finding a way to manage your pain is often easier if it is addressed early.

Source: NIA (NIH)3

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Alzheimer's Disease and Pain

People who have Alzheimerís disease may not be able to tell you when theyíre in pain. When youíre caring for someone with Alzheimerís disease, watch for clues. A personís face may show signs of being in pain or feeling ill. You may also notice sudden changes in behavior such as increased yelling, striking out, or spending more time in bed. Itís important to find out if there is something wrong. If youíre not sure what to do, call the doctor for help.

Source: NIA (NIH)4

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References

  1. Source: NINDS (NIH): ninds.nih.gov/ disorders/ chronic_pain/ detail_chronic_pain.htm
  2. Source: NIA (NIH): nia.nih.gov/ health/ pain-you-can-get-help
  3. ibid.
  4. ibid.

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.