Evaluation of pain in humans

Abstract

A method for evaluating pain experienced by a human is disclosed. The method includes applying a first noxious stimulus to a normative site on the human, wherein the first noxious stimulus is applied below a pain threshold of the human and logging a first information associated with the first noxious stimulus. The method further includes applying a second noxious stimulus to a source of the pain in the human, wherein the second noxious stimulus is applied until pain threshold is reached and logging a second information associated with the second noxious stimulus. The method further includes increasing the second noxious stimulus until pain tolerance is reached and logging a third information associated with the second noxious stimulus. The method further includes continuing to apply the second noxious stimulus until the human can no longer tolerate the second noxious stimulus and logging a fourth information associated with the second noxious stimulus.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority to U.S. provisional patent application Ser. No. 60 / 609,939 filed Sep. 3, 2004. The aforementioned U.S. provisional patent application is hereby incorporated by reference in its entirety.STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT [0002] Not Applicable. INCORPORATION BY REFERENCE OF MATERIAL SUBMITTED ON A COMPACT DISC [0003] Not Applicable. FIELD OF THE INVENTION [0004] The invention disclosed broadly relates to the field of medicine, and more particularly relates to the field of pain management. BACKGROUND OF THE INVENTION [0005] Pain is defined as an unpleasant sensory or emotional experience associated with actual or potential tissue damage. It is epidemic in our country. It is the single most common complaint seen in healthcare. Pain-related prescriptions account for more than one of seven medical prescriptions written each year. The national medical costs alone exceed 100 billion...

AI Technical Summary

Benefits of technology

[0032] Briefly, according to an embodiment of the present invention, a method for evaluating pain experienced by a human is disclosed. The method includes applying a first noxious stimulus to a normative site on the human, wherein the first noxious stimulus is applied below a pain threshold of the human and logging a first information associated with the first noxious stimulus. The method further includes applying a second noxious stimulus to a source of the pain in the human, wherein the second noxious stimulus is applied until pain threshold is reached and logging a second information associated with the second noxious stimulus. The method further includes increasing the second noxious stimulus until pain tolerance is reached and logging a third information associated with the second noxious stimulus. The method further includes continuing to apply the second noxious stimulus until the human can no longer tolerate the second noxious stimulus and logging a fourth information associated with the second noxious stimulus.

Problems solved by technology

These pains often result from alleged injuries where the psychosocial milieu is most intricate.

These issues are compounded because the pain complaint is largely subjective and is difficult to assess in an un-biased, qualitative and quantitative fashion.

This problem is made worse when pain becomes chronic.

Pain, however, is often inadequately evaluated and managed by healthcare professionals because of the complex intermix of components that underlie the individual patient's pain experience.

Unlike the other “vital signs [that are quantifiable and unitary],” pain complaints have been difficult to analyze in a pragmatic and cost-effective fashion.

Biologists recognize that those stimuli which cause pain are liable to damage tissue.

It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience.

There is usually no way to distinguish their experience from that due to tissue damage if we take the subjective report.

This definition introduces the problems underlying the proper assessment of the pain experience.

The net result is that an individual's pain complaints can be a complex mixture of pathophysiologic causes, emotional factors, and social components.

The net result is that there has been a both an under- and over-utilization of medical care because of inaccurate or incomplete diagnoses.

If the major substrate for a patient's voiced complaint lies in the domain of emotional or social etiology (e.g., depression, anxiety, anger, secondary gain), then physical therapy, epidural steroid injections and low back pain will not effectively address the symptoms.

On the other hand, other studies find that the majority of patient's with chronic non-malignant pain do not receive adequate pain control from their treating physicians.

Large population studies document that there is a poor correlation between the severity of the injury, the pain complaints, radiological findings, and the outcome.

Experience suggests that up to one-half of all these “treatment failures” may be due to improperly diagnosed and managed emotional factors.

Two of the social ills that taint the discipline of pain management are substance abuse and malingering.

Allied with these are the issues of drug diversion for sale and distribution.

This problem is again epidemic in our nation.

Extrapolating from this data, one can estimate that there is a substantial risk that substance abusers or addicts or others will present routinely to physicians complaining of chronic pain.

This problem will be even more complex when such individuals have identifiable anatomic entities that are often correlated with but are not inevitably associated with pain syndromes (e.g., herniated spinal discs, arthritic bony changes, fibromyalgia).

Some of this may be due to unmanaged pain, emotional domain issues or social issues.

A key challenge for the future will be the accurate assessment of this population of individuals.

Another social ill of our society is malingering for secondary gain.

Patient fraud is rampant in Social Security, Medicare and Medicaid.

Individuals can suffer pathophysiologic pain complaints and / or emotive pain complaints; these patients however may or may not be motivated to improve.

Although population studies have clearly identified the scope of the problem in the assessment of chronic pain, applying these findings to the individual patient has not been successful.

The complexities of the problem and the limitations of the “bedside” evaluation have resulted in significant diagnostic uncertainty and error.

One limitation is the ambiguity of the patient response.

This will lead to over-prescribing of medications, diagnostic tests or other treatment.

It can lead to unfair compensation or assignment of social disability.

Further, in patients with emotional disorders, the pain symptoms may be tainted by an unconscious exaggeration of the stimulus and or its consequences.

A depressed patient may see the world in more plaintive and melancholic overtones so that everything “hurts more.” This then can lead to inaccurate assessment of the underlying biologic component of the pain.

Another limitation is the incomplete assessment of the patient response.

Another limitation is the imprecision of the evocative stimulus.

They are usually applied once and therefore do not guarantee reproducibility and accuracy.

This leads to a great deal of imprecision in the inferences drawn.

The diagnostic uncertainty and error concerning the individual with pain complaints results in the current quagmire that confronts the medical community and society in general when dealing with this epidemic problem.

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