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1. Microteaching: Pain Assessment Planned for BPT 3year (6 th semester) - - By DR. Pragati chawla

2. Objectives of learning What is Pain (quick revise) Why pain assessment is important Types of pain Components of Pain assessment In brief and importance about every component.

3. Pain What is Pain ? Pain is defined as an unpleasant sensory and emotional experience that is associated with or resembles, actual or potential tissue damage. (Definition given by International Association for the study of pain IASP)

4. Pain Assessment why pain assessment is important? For guiding diagnosis and treatment planning Monitoring progress and treatment effectiveness Identifying psychosocial factors Improving quality of life Basically, pain assessment is fundamental to effective physiotherapy.

5. Types of Pain Acute Pain It is a new pain often severe, continuous and perhaps disabiling . Duration of Pain: 7 to 10 days. Subacute Pain It is a type of pain which is intermittent between acute and chronic Duration of Pain : 7 days to 7 weeks Chronic Pain It is more of aggravating type, is not as intense, and has been experienced before. Duration of Pain: more than 7 weeks

6. Components of Pain Assessment Onset Site of pain Duration Frequency Quality Quantity Diurnal Variation Aggravating factor Reliving factor

7. 1. Onset of pain It is a reference point when a subject first experienced pain . Sudden onset- pain that begins abruptly. Ex- fracture, sprain Gradual onset- pain that develops slowly over time, often starting as mild pain and progressively worsening. Ex.- OA knee, CAI Insidious Onset- Pain that appears gradually without any obvious cause or identifiable event. Eg - bursitis, plantar fasciitis Intermittent Onset- Pain that comes and goes, rather being constant. Ex-Migraine Delayed onset- pain that appears sometime after the intial event. Ex-Delayed onset muscle soreness

8. 2. Site of Pain site of pain refers to specific location where a person feels discomfort. It is crucial for diagnosing the underlying condition, determine the source of pain and planning appropriate treatment. 3. Duration It helps to know whether the pain is acute or chronic followed by deciding a appropriate management. Ex- Acute pain often treatment with Cryotherapy while chronic conditions require hot water fermentation.

9. 4. Frequency The frequency of pain refers to how often a person experiences pain over a given period. Pain frequencies can be used to categories pain under acute and chronic. Ex- constant pain – chronic pain, Occasional pain- minor injury, often acute pain.

10. 5. Quality of pain Quality of pain is an essential factor in determining the origin of pain. Different pain types and related structures- Type of Pain Structure Cramping, dull Muscle Dull aching Ligament , joint capsule Sharp, shooting Nerve root Sharp, bright, lightning like Nerve Throbbing, diffuse vasculature Deep nagging Bone Sharp, severe, intolerable Fracture

11. 6.Quantity Pain quantifying scales are as follows NPRS (numeric rating pain scale) Subjective type of pain rating scale. 2. Visual Anuloge scale (VAS) 3. Mc Gill questionnaire These provides the patient with three major classes of word descriptors- sensory, affective, and evaluative to describe their pain experience. Wong- Baker FACES Pain Rating Scale Mostly used in pediatric population.

12. 7. Aggravating factor Understanding what worsens the pain can help identify potential triggers or activities that should be avoided or modified. 8. Reliving factor Knowing what alleviates pain helps to determine effective strategies or treatments.

13. ANY DOUBTS??

14. Reference Orthopedic Physical assessment – 7 th SAE By David J. Magee