References

Ashelford S, Raynsford J, Taylor V Pathophysiology and pharmacology for nursing students, 2nd edn. : SAGE; 2019

Bannister K Descending pain modulation: influence and impact. Current Opinion in Physiology. 2019; 11:(1)62-66 https://doi.org/10.1016/j.cophys.2019.06.004

Boyd C Clinical skills for nurses, 2nd edn. : Wiley; 2022

Cook N, Shepherd A, Boore J Essentials of anatomy and physiology for nursing practice, 2nd edn. : Sage; 2020

Colvin LA, Carty S Neuropathic pain. In: Colvin LA, Fallon M (eds). : Wiley-Blackwell/BMJ Books; 2012

Cullen M, MacPherson F Complementary and alternative strategies. In: Colvin LA, Fallon M (eds). : Wiley-Blackwell/BMJ Books; 2012

Cunningham S Pain assessment and management. In: Moore T, Cunningham S (eds). : Routledge; 2016

Engel GL The clinical application of the biopsychosocial model. Am J Psychiatry. 1980; 137:(5)535-544 https://doi.org/10.1176/ajp.137.5.535

Flasar CE, Perry AG Pain assessment and basic comfort measures, 10th edn. In: Perry AG, Potter PA, Ostendorf WR (eds). : Elsevier; 2021

Johnson MI The role of transcutaneous electrical nerve stimulation TENS on pain management. In: Colvin LA, Fallon M (eds). : Wiley-Blackwell/BMJ Books; 2012

Keefe FJ, Lefebvre JC, Starr KR From the gate control theory to the neuromatrix. Revolution or evolution?. Pain Forum. 1996; 5:(2)143-146 https://doi.org/10.1016/S1082-3174(96)80052-3

Kettyle A Pain management, 3rd edn. In: Delves-Yates C (ed). : Sage; 2022

Laws P, Rudall N Assessment and monitoring of analgesia, sedation, delirium and neuromuscular blockade levels and care. In: Mallet J, Albarran J W, Richardson A (eds). : Wiley-Blackwell; 2013

Mears J Pain management. In: Dutton H, Finch J (eds). : Wiley-Blackwell; 2018

Melzack R Pain and the neuromatrix in the brain. J Dent Educ. 2001; 65:(12)1378-1382 https://doi.org/10.1002/j.0022-0337.2001.65.12.tb03497.x

Melzack R, Katz J Pain. Wiley Interdiscip Rev Cogn Sci. 2013; 4:(1)1-15 https://doi.org/10.1002/wcs.1201

Smith MT, Muralidharan A Pain pharmacology and the pharmacological management of pain, 3rd edn. In: Van Griensven H, Strong J (eds). : Elsevier; 2023

Todd AJ Anatomy of pain pathways. In: Battaglia AA (ed). : Wiley; 2016

VanMeter KC, Hubert RJ Gould's pathophysiology for the health professions, 7th edn. : Elsevier; 2022

World Health Organization. WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. 2019. https//www.who.int/publications/i/item/9789241550390 (accessed 22 February 2024)

A guide to pain assessment and management in adults

07 March 2024
Volume 33 · Issue 5

Abstract

Pain is universally experienced and extremely complex, involving the mind as well as the body. It is activated by a variety of stimuli, including biological, physical and psychological. This article seeks to provide a deeper understanding of the physiology of pain and the various classifications used in clinical practice. It also aims to raise awareness of the skills that nurses require for the assessment and management of an individual patient's pain. It explores the tools available to assist with the assessment of pain and provides an introduction to some of the management strategies that can be used to manage pain. Some of the barriers to effective pain assessment and management are also examined

Pain is one of the most common patient problems that health professionals will encounter. It is universally experienced and extremely complex, involving the mind as well as the body, and activated by a variety of stimuli, including biological, physical and psychological (Cook et al, 2020).

For some patients, the pain they experience can be short lived and easy to treat, but for others it can cause significant issues to their overall health and wellbeing (Flasar and Perry, 2021). According to Mears (2018), mismanaged pain can affect an individual's mobility, sleep pattern, nutritional and hydration status, and can increase the risk of developing depression or becoming socially withdrawn. This article, therefore, examines and explores some of the holistic nursing assessment and management strategies that can be used by health professionals.

Knowledge of pain processes has changed considerably over the past 500 years, when there was the belief that pain is a sensation linked to body fluid imbalance, evil spirits or a punishment from God (Ford, 2020). In 1965, Melzack and Wall conceptualised and pioneered a new model of pain, referred to as the ‘gate control theory’. They hypothesised that neurons within the superficial dorsal horn of the spinal cord could modulate the flow of signals from the stimulation of peripheral nociceptors (sensory neurons) through the central nervous system to the brain, thus effectively increasing or decreasing the amount of pain experienced (Todd, 2016). They further postulated that the gate control was influenced by psychological and physiological factors and, accordingly, have been credited with taking the first step in recognising the symbiotic relationship and the interactive, interdependent nature of these factors.

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