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Measuring the amount of pain being experienced by a patient is an essential part of chiropractic assessment prior to starting care. However, unlike objective measures such as the degree of spinal curvature or the range of joint movement, the amount of pain cannot be determined directly, but is instead inferred from the patient themselves or from signs usually associated with it. These two methods—patient self-reporting and inference by examination—are the basic tools chiropractors will use to assess a patient’s pain level.
While the degree of discomfort reported by a patient is an important guide, the subjective experience of pain means that each person will have a different level at which they call pain mild, moderate or extreme. Likewise, patients will all have varying degrees of verbal and physical reactions to different levels of soreness. Taken together, however, self-reporting and examination provide a combination of evidence which can be used to determine pain levels with a reasonable degree of accuracy.
Most chiropractors caring for a patient will use an assessment form that asks about the kind of problem that the patient is currently experiencing and the amount of pain it is causing. A basic diagram of the body may also be used to mark locations and levels of pain. Further questions, either in the form of a questionnaire or through a patient interview, may be asked to ascertain the frequency of pain and the nature of movements and activities that may trigger pain or worsen it.
The level of perceived discomfort is often assessed using a pain scale in which the patient is asked to assign a figure to their experience such as from 0 (no pain) to 10 (extreme pain). Although such a scale will be subjective, most patients demonstrate a good deal of internal consistency when it comes to reporting relative pain levels. This means that patient-reporting using this type of pain scale can be useful in determining whether a condition is responding to care over time or getting worse, as well as in determining how pain levels fluctuate over the course of a day or in response to certain kinds of activity. In addition to the simple pain scale, there are several specially designed questionnaires that are also used to assess the degree of pain and disability associated with spinal injuries, such as the Quebec Back Pain Disability Scale.
Chiropractic assessment of a patient actually begins the moment the patient walks in the door. A skilled chiropractor can tell much about a condition and how much pain someone is in by their overall posture, how they walk, facial expressions of discomfort and involuntary verbalization. While being examined, palpation and movement of problem areas will often give rise to further articulation and tensing against painful movement, which provide further clues both to the location and degree of soreness. A chiropractor may use pain scales during the examination so that patients can communicate in a more focused way how much a certain movement or palpation hurts. Marking these pain levels on a chart provides a baseline measurement that a chiropractor can use to judge the effectiveness of pain relief over time.
Pain measurement is only one method of assessing both the degree of injury and success of care. In a wellness, whole body model of chiropractic, it is almost unimportant. Pain IS both a clear sign that something is wrong and an impediment to normal daily activity. Pain IS very important in your life and is the ultimate motivator for us as humans to get help. We listen, we care, we get results. Just don’t judge your health by pain, or the lack there of. Your nerve system is the master system, and is important to evaluate and care for both in times of pain and in times of no pain! Call today to have your evaluation! 253 566-4744
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For years I suffered with severe lower back pain, sciatica, and migraines. Looking back, I'm amazed I could take care of my kids. My husband is in the military and I am a stay at home mom, primarily. Through all our moving around I've seen military docs all over. The answer was always the same: PILLS, PILLS, PILLS! One day at the YMCA in Lakewood, I met Dr. Anderson. He had an information table and it seemed like he might be able to help me. Dr. Anderson made things a lot better and always treated me with respect and courtesy. Thank you, thank you, thank you to all the staff at Discover Chiropractic!