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Department of Anaesthesia, Royal Free Hospital, London, UK
History taking in chronic pain patients should be precise and targeted. The questions should focus on all aspects of pain without compromising on the details. Good listening skills are essential to ascertain good history. A systemic approach to history helps in reaching a definitive diagnosis. The targeted history should be able to distinguish potential emergencies.
Pain can be classified according to the duration. Usually, pain less than 12 weeks is considered as acute and pain extending beyond 12 weeks is termed as chronic. Pain can also be classified according to whether it is nociceptive or neuropathic.
5.1 Mode of Onset and Location
The sudden onset of pain may point to an emergency, e.g. severe headache associated with rupture of aneurysm. More dull and diffuse pain may point to a nonserious cause. Location of the pain helps in targeting the therapy to the right place. The site involved with maximum pain must be ascertained.
5.2 Intensity
The intensity is subjective but can give an indication of the severity of the pain. Various scales have been devised to assess intensity. Most commonly used are Likert-type scales.
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