What is the focus of the history in suspected chronic pain syndrome (CPS)?

Updated: Jan 14, 2020
  • Author: Manish K Singh, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Focus the history on a characterization of the patient's pain. Obtaining the characteristics of the pain helps to establish appropriate diagnostic and therapeutic plans.

  • Pain location - The location of pain is an important part of the history; ask the patient to describe the type of pain and the location on a pain diagram (anterior/posterior and lateral view of human picture)

  • Precipitating factors - Ask questions about factors that provoke or intensify pain; this information may provide clues concerning possible etiologies or associated disorders

  • Alleviating factors - Ask the patient if any factors help to alleviate the pain; for example, rest may decrease pain of musculoskeletal origin

  • Quality of pain - Ask the patient to describe the quality of pain; various terms can be used to describe the quality of pain, including throbbing, pounding, shooting, pricking, boring, stabbing, lancinating, sharp, cutting, lacerating, pressing, cramping, crushing, pulling, pinching, stinging, burning, splitting, penetrating, piercing, squeezing, and dull aching

  • Radiation of pain - Ask the patient if the pain spreads or radiates; spreading or radiating pain is a characteristic of neuropathic pain

  • Severity or intensity of pain - Use some type of rating system to evaluate pain severity or intensity with a degree of objectivity and reproducibility; different types of pain scales may be used, with numerical scales being more useful and reliable (the visual analog scale [VAS] is one of the commonly used numerical scales)


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