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German Pain Society

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Pain history

Current pain diagnostics should, if possible, include all

significant previous findings (including imaging
diagnostics such as X-rays, Doppler, MRI, magnetic
resonance, CT or scintigraphic examinations) as well
as reports from previous treatments. They provide the
therapists with initial indications of the trigger and
maintenance factors that may underlie the pain
symptoms – e.g. functional disorders of the musculo-
skeletal system (muscles, ligaments, tendons and
joints) or pathological changes in the nervous system
(e.g. polyneuropathy or neurological changes after
cerebral infarction) or metabolic disorders (e.g.
rheumatoid processes, diabetes). It is also helpful and
necessary to submit a completed German pain
questionnaire handed out by your doctor before the
first examination, which also includes additional
personal questions about yourself, mood and
sensitivity.
 

In your pain therapy, the anamnesis survey offers you

the perhaps unique opportunity that your pain
symptoms can be comprehensively analyzed with
regard to all relevant medical-physical, psychological
and social aspects. In pain therapy, this usually
requires at least two hours of questioning and
examination by the doctors and psychotherapists
who support you here. Consciously enough time is
given in pain therapy, which you should reserve
yourself.

Patients with chronic pain often have a long "history of

suffering" when they visit pain therapy – shaped by
the development of the pain problem over a period of
weeks, months or years and the very different
experiences with applications or medications that
have helped more or less well. The therapist should
know this "pain history" as well as possible in order to
be able to help in the best possible way. To do this, he
asks the patient about the development and type of
pain (anamnesis). In the conversation, he grasps
essential aspects that are decisive in the search for
the causes of pain and their treatment.

Of course, an accompanying person of your trust

(spouse, children, parents, a trusted person or
caregiver) may accompany you to the initial
reception and can be included in the survey at your
request. Of course, you can also visit the examination
alone to present your problem personally, with regard
to aspects that only you yourself would like to
communicate to the practitioner under the protection
of confidentiality obligations.
 

As part of the pain history, the following

questions are then addressed:

Where, i.e., on which parts of the body, does the

pain occur? Where are the most stressful pain
regions? Often, a so-called pain drawing by
marking the affected pain areas reveals
important features of the pain.

How often does pain occur – continuously,

several times a day or several times a week,
persistently with additional seizures, during the
day and/or at night?
ORIGINAL

Welcher Art sind die

How severe
Schmerzen is the pain?
– eher brennend, So-called pain scales can
stechend, ziehend, bohrend oder
be helpful here.
reißend?

What kind of pain is – burning, stabbing, pulling,

drilling or tearing? Or is the pain more apt to
describe than excruciating, miserable or terrible?

When did the pain start – were there specific

triggers, such as an injury, a cast or an accident?
Were there other personal events and conditions
related to the onset of pain, such as insults and
disappointments, exhaustion and burnout,
separation, divorce, death or excessive demands,
bullying at work, dismissal and unemployment?

To what extent does the pain hinder certain

activities and activities in everyday life and at
work? Under what conditions does the pain
intensify?

Which one Do the pain have consequences for

mood, quality of life and experience in the course
of the disease and also currently?

How has the pain changed over the course of the

disease?

What can reduce the pain? Which treatments –

for example, which medications, operations,
outpatient or inpatient therapies, physical or
other applications – were carried out and with
what success?

Which measures of pain relief do you know and

how and with what effect do you use them in
everyday life?

Since a variety of factors can be important for the

development and maintenance of chronic pain, the
entire life circumstances in connection with the history
of the person concerned are important for the choice
of pain therapy. Both physical and mental injuries of
recent times or in the past (so-called traumatization,
insults or disregard), experiences of loss (separation,
death) or special burdens (excessive demands,
caring for a relative, own illnesses) can contribute to
the pain.

Answering personal questions as openly as possible is

therefore helpful. In individual cases, it may also be
useful to answer special questionnaires to classify the
complaints, which should help to understand
particular aspects of the disease. This is always your
individual point of view.

Please be sure that pain therapists always take your

complaints seriously – even if you may have had
other experiences in the past. Therefore, describe your
burdens just as impartially, without particularly
emphasizing or even having to prove them, or
withholding individual aspects.
 

You yourself are always the first expert

for your pain. Perhaps, with the help of
your therapists, you can also become an
expert in your own pain management!

With many thanks to the author Wolfgang Richter

© 2019 German Pain

Society e.V.

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