Continuing with our discussion of the role of assessment in the doctor’s SOAP interview, I want to return to a topic discussed before: the character of pain.

Pain is a good example of the conundrum doctors’ face with regard to “assessment.” The experience of pain is subjective; objective qualifiers, such as X-rays and MRIs, do not give us much insight. “Findings” of pain at the tissue level often do not correlate with the pain experience.

Given how little is really known about pain, the real problem is the lack of research in solutions for pain management or treatment. In fact, the usefulness of the term “chronic pain” has recently been questioned, since the duration of pain is less relevant than multifactorial components, which are subjective at best. The risk factors and low response rate of surgeries, as well as the statistically insignificant benefits of pain medication, demonstrate that the helping of people who are experiencing pain is in its infancy. As Assessment is required prior to the Plan, what can we offer these patients?

In light of the recent research on techniques and modalities or approaches that deal with pain, I can comfortably say that I would be terribly discouraged if it were not for my clinical experience.
The philosophy of my clinic, the “prime directive” so to speak, is to deal with the pain first. Despite the beneficial health sustaining and health-promoting methods available, I have found in my practice that people suffering from pain are focused primarily on obtaining relief for their pain.

I’ll tell you specifically how I do this in my next post. Look forward to seeing you there.