How to measure pain

P.Q.R.S.T.P.Q.R.S.T. …..is an acronym that helps you to measure pain by asking fundamental questions

PPALLIATIVE OR PROVOKING

What makes you feel better or worse?

QQUALITY

What is the pain like?What kind of pain is it?

Can you describe the pain?

RREGION

What is the region involved? Where does it hurt?

Does the pain radiate?

SSEVERITY

How much does it hurt? Can you still work?

Are you incapacitated? Are you able to sleep, to work?

TTIME/TEMPORAL

When does the pain occur? Is the pain intermittent or constant?

What time of the day do you feel the pain?

The different kinds of painAcute

ChronicMalignant

Non-malignantSomatic

Neuropathicvisceral

Acute painBegins suddenlySharp in qualityClear defined cause – injury, tissue damageSpecific disease

Chronic painPain may subside as healing proceedsContinues over timeDull or more severeLasts for more than 3 months

malignantFrom cancer

radiation therapy chemotherapy

Non-malignantNot life-theatening

somatic…Coming from

skinBoneJoint muscle

neuropathicDamage to nerve

visceralComing from internal organs

Pain examplesANGINA PECTORIS

“TIGHT CHEST”TYPICAL MYOCARDIAL INFARCTION PAIN

CAUSED BY atherosclerosis (hardening of arteries)

People with angina experience pain in the centre of the chest. The chest can feel constricted and tight, but the pain can also be

oppressive, as if something is crushing your chest. Pain starts in the centre of the chest behind the breast bone

(sternum) or on the left side of the front of the chest. It can spread out to other parts of your body like your arms and stomach.

 http://www.netdoctor.co.uk/diseases/facts/angina.htm#ixzz2xuJzE13B 

Angina pectoris

Heartburn painHeartburn is a painful burning feeling just

below or behind the breastbone. Most of the time it comes from the esophagus. The pain often rises in your chest from your stomach and may spread to your neck or throat.

http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm

HEARTBURN PAIN REGION

Heartburn or heart attack?

HEARTBURNIt usually occurs after eating or while lying

down or bending.It can be brief or continue for a few hours.You notice a burning sensation in your chest

that may start in your upper abdomen and radiate all the way to your neck.

Stomach acid that moves up into the esophagus

QUIZ

What is HYPERALGESIA?

An increased sensitivity to pain

paresthesiaAn abnormal sensation (not unpleasant)

Part numbed or insensitive “pins and needles” sensation

myalgiaMuscle pain

Pain in a limb that has been amputated…Phantom pain

Arthralgia and neuralgiaJoints and nerve pain

The most common site of joint pain?The knee

analgesiaWithout pain

C.I.P.A.Congenital Insensitivity to Pain with

Anhidrosis

A rare disorder where there is total absence of pain and sweating

No feelings of pain even with damage or injury

Ability to keep tollerate freezing temperatures

Pain is measured…0-10

0 - no pain10 – worst pain

NarcoticsUsed to induce stupor

Poena - painFrom Latin meaning penalty

Pain thresholdWomen have a higher tollerance of pain

DeliveryLabourMenstrual pain- Dysmenorrhea