Over the past two weeks has pain been bad enough to interfere with your day to day activities?
Over the past two weeks have you felt worried or low in mood because of this pain?
These two questions were created by the Faculty of Pain Medicine, following extensive consultation, as an early pre-screening and management tool to reduce the burden of pain. The aim was to develop consensus around the use of a brief tool that is extremely quick to use and can help with decisions about whether further screening, assessment and early management (including possible referrals) is necessary. Anecdotal reports from primary care practitioners are that they do not have the time to screen all patients presenting with pain and yet are not sure when to introduce screening for those patients whose pain is not resolving. Therefore, developing a pre-screening tool for pain would address this, as it has in screening for depression. The questions evaluate:
Pain duration ‘..past two weeks..’
Pain intensity ‘..pain been bad enough..’
Level of pain related disability ‘..day-to-day activities..’
Level of pain related distress ‘..worried or low in mood..’
Early screening and management is essential for patients in order to help reduce the burden of their pain. Currently NHS services are reactive rather than proactive in managing people with pain. There is not enough emphasis on identifying those with acute pain who are at risk of developing chronicity (pain related disability) or people who have chronic pain and are not, or are no longer, coping with their pain. Pain is very common, often complex, and it can cause wide-ranging biopsychosocial issues that are often unrecognised and unaddressed. However, there are strategies available that can prevent many of the biopsychosocial issues, some of which are best/most effective when implemented early. If this screening tool above is effectively adopted, it will be able to greatly help patients
We thank Dr Ann Taylor, Dr Chris Barker and Dr Andy Nicolaou for leading this project.