Pain has been defined by the International Association for the Study of Pain (IASP) as “An unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage, or both.”

Pain is inherently subjective, therefore patient self report is the only way to assess the problem for relevant diagnosis or management. Ideally, the description of the pain should characterize its severity, topography, quality and factors that re–emit or relieve it.

Pain Intensity
Measuring pain severity is essential and may have important therapeutic implications. Pain can be measured validly and reliably using simple scales or instruments. For chronic pain, setting a time frame may be useful, such as the past week or the past month, and then obtaining separate measurements for pain in general, pain at its worst, and pain at its least. The descriptions used by patients to describe the quality of the pain are considered to diagnose the underlying pathology.

Pain that appears to be sustained by ongoing activation of pain–sensitive nerves, or nociceptive pains, are generally described as familiar by patients. If the injured tissue is somatic, such as bone, the pain is often described as aching or throbbing, and sometimes stabbing. If injury is to skin, then it is often described as burning. If the injured tissue is visceral, the pain often varies with the structures involved and is described as cramping or gnawing pain pattern and is referred to common cutaneous sites. Damage to other visceral tissues, such as mesentery, is associated with pain that is described as aching, stabbing, or throbbing.

Why Pain Management?
Have you ever asked yourself, “Why do I need another doctor for pain management?” Many people with chronic pain have seen multiple specialists from neurologists, orthopedics therapists to psychologists. They continue to suffer and do not know what to do. There are many reasons why they should see a pain specialist. First, you need to understand the specific reason for your pain, then more focused and individualized treatment can be implemented. This evaluation is as important as all other tests. (MRI, X–ray, etc.). Reassurance and re–evaluating treatment may be necessary. Lastly, if nothing can be done medically, you should begin to live with your pain under pain specialists’ guidance and continue to maintain your physical and medical condition to the best of your capacity.

Remember: Chronic pain is not a choice but suffering is. What is the scope of pain management?
Pain management includes different modalities and treatments such as medication therapy, injections or nerve blocks, physical therapy and reactivation, psychotherapy, biofeedback, acupuncture, and other implantable devices. Pain centers usually offer more than one type of treatment. You may be referred for one specific treatment such as nerve block only.