University at Buffalo

Behavioral Medicine Clinic

 
 

Chronic Pain Screening

doctor at desk

Many patients suffering from chronic pain disorders are reluctant to seek treatment or have been frustrated by previous encounters with health care professionals. Physicians play a crucial role in guiding these people to seek evidence-based treatment for symptoms that have not adequately responded to drugs or traditional therapies. Here are some suggestions for screening a patient who may have a persistent pain disorder:

Clinical Issues

  • Has the pain persisted for 3 months or longer despite appropriate interventions and in the absence of progression of the disease?
  • Does the patient report a nonorganic pattern of pain?
  • Does the patient have unrealistically high expectations of treatment offered (e.g., looking for a complete “cure” or “fix”)?
  • Does the patient express dissatisfaction with the relief traditional medical treatments provide?

Behavioral Issues

  • Does the patient link the onset or worsening of pain to any major stressful event?
  • Does the patient report depressed or anxious mood?
  • Has the patient given up many activities because of pain (social, recreational, physical, occupational)?
  • Does the patient rely on problem coping responses such as excessive alcohol, medications, or avoidance behaviors to relieve pain?
  • Does patient display many pain behaviors such as grimacing or moving in a rigid and guarded fashion?

Social Issues

  • Is there a high level of family or marital strain?
  • Does the patient's partner provide excessive attention to pain behaviors such as taking over chores or rubbing patient's back?
  • Does anyone else in the patient's family have chronic pain?
  • Does the patient have no plan for increased or renewed activities if pain is reduced?

Legal and Occupational Issues (Work or Auto Accident Cases)

  • Is there litigation pending?
  • Is the patient receiving disability compensation?
  • Was the patient employed prior to pain onset?
  • Was the patient injured on the job?
  • Does the patient have a job to which he or she can return?
  • Does the patient have a history of frequently changing jobs?

Positive responses to 5 or more answers may not adequately respond to medical treatment and warrant a more extensive evaluation which can be arranged by calling the Behavioral Medicine Clinic at (716) 898-5671.