Module 2 Discussion: Initial Post
Assessing Pain That Started Yesterday and Pain That Started Years Ago
Acute and chronic pain call for different assessments because they mean different things. The revised IASP definition describes pain as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage, and adds that pain is always a personal experience influenced by biological, psychological, and social factors (Raja et al., 2020). Acute pain usually signals current tissue injury and resolves as it heals. Chronic pain, persisting or recurring for longer than three months, may continue after healing and can become a condition in its own right (Treede et al., 2019).
Assessment follows from that difference. In acute pain, the priority is finding the cause and gauging severity: onset, location, character, radiation, intensity on a numeric scale, and associated signs that point to a diagnosis, such as guarding, swelling, or deformity. The pain score guides immediate treatment and is repeated after each intervention. In chronic pain, intensity alone says little. The assessment must also cover function (what the person can and cannot do), sleep, mood, fear of movement, coping strategies, previous treatments and their effects, substance use, and the patient's goals. In chronic pain, the question shifts from how much it hurts to how much it is taking from the person's life.
A recent patient illustrates my own learning. A composite 52-year-old warehouse worker came to our clinic with eight years of low back pain. My first assessment was an acute-style one: a pain score of 7 out of 10, location, and radiation to the left buttock. It told me almost nothing new. When I returned with functional questions, I learned that he had stopped fishing with his grandson, slept four hours a night, and believed any bending would "break" his back. A brief screen suggested depression. That second assessment changed the plan more than the first.
Treatment options for him centered on function rather than elimination of pain: physical therapy with graded activity to address his fear of movement, cognitive behavioral approaches, sleep hygiene, treatment of his depression, and nonopioid medicines where appropriate. The CDC guideline advises that nonopioid therapies are preferred for chronic pain and that opioids should be considered only if expected benefits outweigh risks, with realistic goals for pain and function (Dowell et al., 2022). Setting a goal he cared about, fishing again, gave us a measure of success that a pain score never could.
How do others assess function in chronic pain within a short visit? Do you use a specific tool?
References
Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC clinical practice guideline for prescribing opioids for pain: United States, 2022. MMWR. Recommendations and Reports, 71(3), 1-95. https://doi.org/10.15585/mmwr.rr7103a1
Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M., Sluka, K. A., Song, X.-J., Stevens, B., Sullivan, M. D., Tutelman, P. R., Ushida, T., & Vader, K. (2020). The revised International Association for the Study of Pain definition of pain: Concepts, challenges, and compromises. Pain, 161(9), 1976-1982. https://doi.org/10.1097/j.pain.0000000000001939
Treede, R.-D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., First, M. B., Giamberardino, M. A., Kaasa, S., Korwisi, B., Kosek, E., Lavand'homme, P., Nicholas, M., Perrot, S., Scholz, J., Schug, S., ... Wang, S.-J. (2019). Chronic pain as a symptom or a disease: The IASP classification of chronic pain for the International Classification of Diseases (ICD-11). Pain, 160(1), 19-27. https://doi.org/10.1097/j.pain.0000000000001384
How this N 518 Module 2 example is structured
N518 Module 2's discussion typically asks you to distinguish how acute and chronic pain are assessed and then reflect on a pain assessment you performed, including its effectiveness and treatment options. The module's ShadowHealth work is your own and is not sampled. Aspen revises courses, so check your classroom's prompt. This example defines both with current sources, contrasts what each assessment must cover, reflects honestly on an incomplete first assessment and ends with a question for peers.
N518 Module 2 questions, answered
What does N518 Module 2 usually ask for?
The discussion asks you to explain how acute and chronic pain assessment differ and to reflect on a pain assessment you performed, including how effective it was and the treatment options. ShadowHealth work for the module is your own.
How long does pain last before it is called chronic?
The IASP classification used in ICD-11 defines chronic pain as pain that persists or recurs for longer than three months.
What should a chronic pain assessment include beyond a pain score?
Function and daily activities, sleep, mood, fear of movement, coping, previous treatments, substance use and the patient's own goals, because intensity alone says little about the impact of long-term pain.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.