Five questions you should ask a patient in pain

I recently did a talk for a bunch of GP’s. The brief I got was to make the really tough task of assessing someone in pain a little easier – ‘Perhaps you could tell them which questions to ask’ were the exact words I think. So, here are the slides.  I have tried to make the pretty self explanatory, although Heidi has been trying to get me to do a voice over – she has lost patience and got me to write an intro instead.  The general feel of this presentation is covered in detail in:

There are some good papers, many by Rolf Treede and his German neuropathic pain network people, on testing for neuropathic pain – go here:

Enjoy!

If you’d like a pdf of this presentation to download click on the slideshare here or in our slide section

grey Five questions you should ask a patient in painMoseley G Lorimer (2007). Reconceptualising pain according to modern pain science Physical Therapy Reviews, 12 (3), 169-178

Moseley GL (2003). A pain neuromatrix approach to patients with chronic pain. Manual therapy, 8 (3), 130-40 PMID: 12909433

Treede, R., Jensen, T., Campbell, J., Cruccu, G., Dostrovsky, J., Griffin, J., Hansson, P., Hughes, R., Nurmikko, T., & Serra, J. (2008). Neuropathic pain: Redefinition and a grading system for clinical and research purposes Neurology, 70 (18), 1630-1635 DOI: 10.1212/01.wnl.0000282763.29778.59

Comments

  1. Nicely put Lorimer! My only comment is that it’s very difficult for some health professionals (from any professional background) to start to ask these questions – because of the can of worms they may open up, lack of time in a consultation, and lack of confidence to know what to do with the answers! I’ve been teaching medics for some years now, and the two questions I suggest they ask themselves are:
    – What has caused this person to present to me in this way at this time?
    – What can be done to reduce distress and disability for this person?
    These two questions came from Dr Nicholas Kendall, and really open up the whole idea of the biopsychosocial model – and introduce the idea that pain reduction alone doesn’t always ‘fix’ the problem.
    cheers
    Bronnie

    Lorimer Reply:

    fair play Bronnie –
    Nice questions from Nick too. I appreciate the relative accessibility of cans of worms, although sometimes i wonder if we are so unsure of our capacity to understand patients that we interpret what is a complex but relatively normal human for a can of worms. This is clearly a cab-sav conversation. Keep up the valuable contributions Bronnie!