Recognizing Pain in Others Helps Decrease Risk for Violent Behavior

It is useful to know if we have someone close to us who is in pain. If not out of compassion for their suffering, recognizing pain in other people helps us to protect ourselves and to decrease the risk for violent behavior. Pain, especially chronic pain, can drive people to commit acts of violence, such as becoming verbally abusive, that more often than not are out of character.

Violence against physicians and healthcare workers committed by patients who are in great pain is an indication that pain must be attended to for one’s own sake if not for the sake of the person in pain.

The experience of pain is different for different people. It is subjective and individual. The best way to find out if someone is in pain is when he or she expresses it. We can find out if the person is in pain by asking him or her “Are you in pain?”, “Is it sore?" or “Does it hurt?”. In some situations, people may not be able to answer questions out loud. If they have a hard time using words to tell you how they feel, pay attention to non-verbal signs of pain and distress or changes in their behavior.

Pain can be acute or chronic, localized or spread out. Pain interventions are adapted to the nature of the pain.

How can we tell if someone is in pain?

The more symptoms a person has, and the more intense these symptoms appear to be, the better will be your understanding of the degree of pain he or she is experiencing.

To figure out if the person is experiencing pain, look for non-verbal signs of pain, which include:

Facial Expressions:

Facial expressions are a form of nonverbal communication such as:

• Slight frown, sad or frightened face.
• Grimacing, wrinkled forehead, closed or tightened eyes.
• Any distorted expression.
• Rapid blinking.
• Clenched teeth.

Verbalization and Vocalization:

There is subtle difference in meaning between vocalize and verbalize. Vocalize is when we express a thought or emotion with our voice. Verbalize is when we speak or use words to express.

• Sighing, moaning, groaning.
• Grunting, chanting, calling out.
• Noisy breathing.
• Asking for help.
• Verbally abusive.

Body Movements:

Notice if there are any:

• Changes in daily activities.
• Rigid, tense body posture, guarding a part of the body.
• Fidgeting.
• Increased pacing or rocking.
• Restricted movement.
• Different gait or limited mobility.

Changes in Daily Activities

• Refusing to eat, change in appetite.
• Increase in the need to rest or to rest for longer periods of time.
• change in the patterns of sleep or rest.
• Sudden change in usual routine.
• Increased wandering or pacing.

Changes in Thinking or Emotions

Chronic pain seriously affects a person’s daily activities and quality of life, but also his / her social and family environment. They might exhibit the following:

• Aggressive and combative attitude.
• Refuse or resisting care.
• Reduced social interactions.
• Socially inappropriate, disruptive behavior.
• Too withdrawn and quiet.
• Increased lack of mental clarity.
• Irritability or distress.
• Crying.

Physical Changes

• Increased heart rate, blood pressure or sweating.
• Limited range of motion or slow movement.
• Guarding a particular body part or reluctant to move.

Strategies for pain relief are adapted to the nature and length of time of the pain and to the health condition of the person in pain.

• Taking pain killers to relieve pain in a safe way.
• Physical therapies such as heat or cold packs, massage, hydrotherapy and exercise.
• Psychological therapies such as cognitive behavioral therapy, relaxation techniques, and meditation.
• Mind and body techniques such as yoga practice.
• Occupational therapy to help solve the problems that interfere with the ability of a person to do things that are important to him or her:
• • Self-care such as getting dressed, eating, moving around the house.
  • Being productive such as going to work or school, participating in the community.
  • Leisure activities such as sports, gardening, social activities.

Strategies for pain management include using drugs to relieve pain and treat its underlying cause, observing physiological or behavioral changes. With the exception of minor pain, strategies for pain relief should include more than one method of treatment to give an optimal relief. It is crucial to have a full assessment of the person in pain done. This helps to determine pain interventions, and people in pain are the most effective to provide information about their pain.