Pain is a universal phenomenon. It is experienced across all age groups, across all socioeconomic levels, and in all settings. Pain exists within the context of a culture, as well as within personal, physical, and psychological history. Its treatment, therefore, should be multidisciplinary. Pain and the search for relief is one of the primary reasons a client accesses the healthcare system.
Pain is also one of the most complex and challenging problems in health care and biology. The sufferer must learn to live with the pain, the healthcare provider must seek every possible means to help the sufferer, the scientist must try to understand the mechanisms of pain, and society must find medical, scientific, and financial resources to relieve or treat pain and suffering as much as possible (Lynch, Craig, and Peng, 2011).
Pain interferes with virtually every aspect of life—sleep, work, socializing with family and friends, hobbies, and activities of daily living. The French physician, Dr. Albert Schweitzer, stated in 1931 “Pain is a more terrible lord of mankind than even death itself.” (U. S. Department of Health and Human Services [USDHHS], 2013). Pain is associated with injuries and disease. Sometimes pain is the cause of disease (such as in headaches or neuropathic pain), and sometimes it occurs as a result of a specific condition (such as postoperative pain). Tens of millions of people suffer from pain in the United States and this number is increasing due to an aging population. It exacts a tremendous cost in the United States, including healthcare costs, rehabilitation and lost worker productivity, as well as emotional and financial burdens for patients, families, and society. Globally, an estimated 20% of adults suffer from pain and 10% of the global population is diagnosed with chronic pain every year (Goldberg & McGee, 2011).
More Americans are affected by pain than by diabetes, heart disease, and cancer combined (American Academy of Pain Medicine [AAPM], 2017). Often, the health care provider is called on to intervene when the client’s perceived cause of pain requires intervention or when the pain interferes with activities of everyday living.
The pain management process is often complicated. It requires an accurate assessment for the presence, type, severity, location, and possible causes of pain. Adequate and useful assessment parameters can vary widely with many types of clients. There is no one “magic formula” that is useful in assessing the pain of all clients. Once assessments are completed, the identification and provision of various interventions to treat and prevent pain are an essential part of the treatment process. An ever-expanding arsenal for pain relief is at the fingertips of health care professionals, and interventions often change depending on client goals. Continued education and an open mind to traditional as well as nontraditional approaches to pain relief provide many alternatives to use when designing a plan for relieving pain (Pasero & McCaffery, 2011).
Finding ways to implement the pain relief plan depends on the client’s needs, beliefs, culture, and goals; the setting in which the client lives and works as well as the setting in which the pain relief will be delivered; whether or not the client has significant others to assist him or her; and available resources for receiving and paying for treatment. The health care provider must continuously evaluate the client’s outcomes and satisfaction with results of the pain relief plan to effectively and appropriately guide any revisions to the plan and to facilitate optimal pain relief. Ongoing communication between the client, family caregivers, and other health care providers is generally essential. Clear, concise documentation provides evidence of the plan, its effectiveness, and any necessary revisions, as well as being a powerful and necessary tool for communication (Pasero & McCaffery, 2011).