TOOLS Locate the Pain Body Maps Body

TOOLS

Locate the Pain: Body Maps Body maps are useful for the precise location of pain symptoms and sensory signs. * *In cases of referred pain, the location of the pain and of the injury or nerve lesion/dysfunction may not be correlated Gilron I et al. CMAJ 2006; 175(3): 265 -75; Walk D et al. Clin J Pain 2009; 25(7): 632 -40.

Pain History Worksheet • • • Site of pain 1 What causes or worsens the pain? 1 Intensity and character of pain 1 Associated symptoms? 1 Pain-related impairment in functioning? 1 Relevant medical history 1 Patient history and physical exam are usually sufficient to determine a functional diagnosis 2 1. Ayad AE et al. J Int Med Res 2011; 39(4): 1123 -41; 2. IASP. Available at: http: //www. iasppain. org/files/Content. Folders/Global. Year. Against. Pain 2/Visceral. Pain. Fact. Sheets/3 -Acute. Vs. Chronic. pdf. Accessed 1 December, 2014.

Determine Pain Intensity Simple Descriptive Pain Intensity Scale Mild pain No pain Moderate pain Severe pain Worst pain Very severe pain 0– 10 Numeric Pain Intensity Scale 0 No pain 1 2 3 4 5 Moderate pain 6 7 Faces Pain Scale – Revised International Association for the Study of Pain. Faces Pain Scale – Revised. Available at: http: //www. iasppain. org/Content/Navigation. Menu/General. Resource. Links/Faces. Pain. Scale. Revised/default. htm. Accessed: July 15, 2013; Iverson RE et al. Plast Reconstr Surg 2006; 118(4): 1060 -9. 8 9 10 Worst possible pain

APS Questionnaire • Measures 6 aspects of quality: – Pain severity and relief – Impact of pain on activity, sleep and negative emotions – Side effects of treatment – Helpfulness of information about pain treatment – Ability to participate in pain treatment decisions – Use of non-pharmacological strategies Gordon DB et al. J Pain 2010; 11(11): 1172 -86.

Brief Pain Inventory Cleeland CS, Ryan KM. Ann Acad Med Singapore 1994; 23(2): 129 -38.

Mc. Gill Pain Questionnaire Melzack R. Pain 1975; 1(3): 277 -99.

Pain Assessment: PQRST Mnemonic • • • Provocative and Palliative factors Quality Region and Radiation Severity Timing, Treatment Budassi Sheehy S, Miller Barber J (eds). Emergency Nursing: Principles and Practice. 3 rd ed. Mosby; St. Louis, MO: 1992.

ISSVD Vulvodynia Pattern Questionnaire Full questionnaire ISVVD = International Society for the Study of Vulvovaginal Disease Available at: https: //netforum. avectra. com/temp/Client. Images/ISSVD/3 ef 9 c 6 ea-aac 7 -4 d 2 b-a 37 f-058 ef 9 f 11 a 67. pdf. Accessed March 24, 2015.

Vulval Pain Functional Questionnaire Available at: http: //www. medstarhealth. org/content/uploads/sites/8/2015/02/PMand. R_Vulvar. P ain. Questionnaire 111910. pdf. Accessed March 24, 2015. Full questionnaire

Vulval Pain Questionnaire Full questionnaire Available at: http: //www. vulvalpainsociety. org/vps/images/pdf/vulval_pain_questionnaire_final_for_bssvd. pdf. Accessed March 24, 2015.

Depression Scales

PHQ-9 Kroenke K et al. J Gen Intern Med. 2001; 16(9): 606 -13.

Hamilton Depression Rating Scale (HAM-D)

Montgomery-Åsberg Depression Rating Scale Montgomery SA, Asberg M. Br J Psychiatry. 1979; 134: 382 -9.

Beck Depression Inventory Beck AT et al. Arch Gen Psychiatry. 1961; 4: 561 -71.

Anxiety Scales

Beck Anxiety Inventory Beck AT et al. J Consult Clin Psychol. 1988; 56(6): 893 -7.

Hamilton Anxiety Rating Scale (HAM-A) Hamilton M. Br J Med Psychol. 1959; 32: 50 -5.

Hospital Anxiety and Depression Scale - Anxiety Question Frequency Score I feel tense or “wound up” Most of the time A lot of the time Occasionally Not at all 3 2 1 0 I get a sort of frightened feeling as if something awful is about to happen Very definitely and quite badly Yes, but not too badly A little, but it doesn’t worry me Not at all 3 2 1 0 Worrying thoughts go through my mind A great deal of the time A lot of the time From time to time, but not often Only occasionally 3 2 1 0 I can sit at ease and feel relaxed Definitely Usually Not often Not at all 0 1 2 3 I get a sort of frightened feeling like “butterflies” in the stomach Not at all Occasionally Quite often Very often 0 1 2 3 I feel restless as I have to be on the move Very much indeed Quite a lot Not very much Not at all 3 2 1 0 I get sudden feelings of panic Very often indeed Quite often Not very often Not often at all 3 2 1 0 Zigmond AS, Snaith RP. Acta Psychiatr Scand. 1983; 67: 361 -70.

Pain Disability Scale

Pain Disability Index Tait RC, Chibnall JT, Krause S. The Pain Disability Index: psychometric properties. Pain. 1990; 40: 171 -82.

Literature Cited Ayad, A. E. , Ghaly, N. , Ragab, R. , Majeed, S. , Nassar, H. , Al Jalabi, A. , … Schug, S. A. (2011). Expert panel consensus recommendations for the pharmacological treatment of acute pain in the Middle East region. The Journal of International Medical Research, 39(4), 1123– 1141. Beck, A. T. , Epstein, N. , Brown, G. , & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893– 897. Beck, A. T. , Ward, C. H. , Mendelson, M. , Mock, J. , & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561– 571. Budassi Sheely, S. , & Miller Barber, J. (1992). Emergency Nursing: Principles and Practice. St Louis: Mosby. Cleeland, C. S. , & Ryan, K. M. (1994). Pain assessment: global use of the Brief Pain Inventory. Annals of the Academy of Medicine, Singapore, 23(2), 129– 138. Gilron, I. , Watson, C. P. N. , Cahill, C. M. , & Moulin, D. E. (2006). Neuropathic pain: a practical guide for the clinician. CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 175(3), 265– 275. http: //doi. org/10. 1503/cmaj. 060146

Literature Cited Gordon, D. B. , Polomano, R. C. , Pellino, T. A. , Turk, D. C. , Mc. Cracken, L. M. , Sherwood, G. , … Farrar, J. T. (2010). Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) for quality improvement of pain management in hospitalized adults: preliminary psychometric evaluation. The Journal of Pain: Official Journal of the American Pain Society, 11(11), 1172– 1186. http: //doi. org/10. 1016/j. jpain. 2010. 02. 012 Hamilton, M. (1959). The assessment of anxiety states by rating. The British Journal of Medical Psychology, 32(1), 50– 55. Kroenke, K. , Spitzer, R. L. , & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606– 613. Melzack, R. (1975). The Mc. Gill Pain Questionnaire: major properties and scoring methods. Pain, 1(3), 277– 299. Montgomery, S. A. , & Asberg, M. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry: The Journal of Mental Science, 134, 382– 389. Tait, R. C. , Chibnall, J. T. , & Krause, S. (1990). The Pain Disability Index: psychometric properties. Pain, 40(2), 171– 182. Vulval Pain Society. (n. d. ). Vulval Pain Questionnaire. Retrieved June 25, 2015, from http: //www. vulvalpainsociety. org/vps/images/pdf/vulval_pain_questionnaire_final_for_bssvd. pdf

Literature Cited Vulvar Pain Questionnaire. (n. d. ). Retrieved June 25, 2015, from http: //ct 1. medstarhealth. org/content/uploads/sites/8/2015/02/PMand. R_Vulvar. Pain. Questionnai re 111910. pdf Walk, D. , Sehgal, N. , Moeller-Bertram, T. , Edwards, R. R. , Wasan, A. , Wallace, M. , … Backonja, M. M. (2009). Quantitative sensory testing and mapping: a review of nonautomated quantitative methods for examination of the patient with neuropathic pain. The Clinical Journal of Pain, 25(7), 632– 640. http: //doi. org/10. 1097/AJP. 0 b 013 e 3181 a 68 c 64 Zigmond, A. S. , & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361– 370.