Some of our computer-based documentation program changed this week at work, which included a new section of documentation called "Pain". While most therapists included a patient's complaints or denial of pain somewhere within their notes previously, this new section is completely dedicated to the description, factors and treatment regarding pain.
Obviously our field of work involves pain - we are the experts in helping patients move better and feel better. Thousands of therapists work each day in determining causes of pain, exacerbating and reliving factors and in maintaining a pain-free lifestyle. Patients with chronic pain syndrome, fibromyalgia and countless other diagnoses are plagued with pain to the extent that it changes the way they live their lives, altering their schedules and limiting work and personal activities.
Having this new "pain box" makes me realize how much effort and focus physical therapists, as well as countless other health care providers, focus on pain. It even has its own box! There are some patients who will deny obvious surgical pain until they are practically in tears, while other patients describe 10/10 pain for seemingly minor strains. It can be difficult to determine the true degree of pain until you have established a good rapport with the patient or have become a good judge of consistent behaviors. It is such a subjective measure.
For the purposes of my physical therapy practice, pain is just one of countless factors I consider with my patients. I consider range of motion and functional strength to be equally as important. However, these things are also dependent on the setting of practice. In an outpatient setting, it is generally assumed that a patient will have full ROM and strength and have only one or two deficits- including pain, which need attention. In an acute care setting, the focus of pain may take a back seat to ambulation, transfers and stairs- as these are the factors more directly related to discharge planning.
What do you think? Do you place a heavy emphasis on pain, or do your treatment plans focus on other factors? Is it right to start a conversation with, "Are you having any pain?" - Therefore drawing more attention to the pain?