First Aid for Pain

Pain is a protective sensation triggered by activated pain receptors, alerting us to injury or illness. Individual “pain thresholds” vary, so severity is subjective but always important to address promptly

In the medical field, this type of questioning is a systematic way to help someone in pain right away. Its goal is to assess the pain that the victim experiences so that they can provide care and pain relief.

Types of Pain

There are five common types of pain, but some can fit into more than one category, which is where the complication comes in.

• Acute pain – this type of pain is mostly related to a soft-tissue injury or temporary illness. It typically subsides after a few minutes or days.
• Chronic pain – pain that is longer in duration and can be constant or intermittent. It is often due to several health conditions like arthritis, fibromyalgia, a spine condition, and even chronic headache.
• Neuropathic pain – occurs when there is damage to the nerves or some parts of the nervous system. It is described as a stabbing or burning pain or feeling like being pinched with pins and needles. You may also experience difficulty in feeling sensations.
• Nociceptive pain – a type of pain caused by damage to body tissues. It is often described as feeling a sharp, achy, or throbbing pain. It is caused by external injuries such as hitting your elbow, stub toe, ankle twist, falls, and scraped knees.
• Radicular pain – a specific type of pain that occurs when the spinal nerve gets compressed or inflamed.

How Does Pain Work

Pain is a sensation that happens when our pain receptors activate in response to a stimulus. Experts believe it is your body’s way of alerting you that something is wrong.

For instance, if you accidentally put your hands on a hot stove, the pain receptors activate, and your brain will cause a muscle contraction (reflex) to pull your hands away from the stove.

However, the pain caused by these experiences varies from person to person. We call this phenomenon the “pain threshold”—it’s why some pain is severe to some people but minimal to others.

Pain Assessment

• For nonverbal patients, use observational tools like FLACC (Face, Legs, Activity, Cry, Consolability) to gauge discomfort.
• Rate the pain intensity using a simple scale (0–10) or visual aids (e.g., faces scale for children).
• Characterize the pain with the PQRST mnemonic:
• Provokes/Palliates
• Quality (sharp, dull, throbbing)
• Region/Radiation
• Severity (0–10)
• Timing (onset, duration)

Different Rating Scales

Pain rating scales are essential tools for assessing pain intensity, quality, and impact—especially since pain is subjective and varies widely between individuals. Here’s a structured overview of the most commonly used pain scales, categorized by type and patient population:

1. Numerical Rating Scale (NRS)

• How it works: Patients rate their pain on a scale from 0 (no pain) to 10 (worst imaginable pain).
• Best for: Adults and older children who can quantify their pain.
• Pros: Quick, easy, and widely used in clinical settings.

2. Wong-Baker FACES Pain Rating Scale

• How it works: Uses facial expressions paired with numbers (0–10) to help patients indicate pain intensity.
• Best for: Children over age 3, individuals with language barriers, or cognitive impairments.
• Pros: Visual and intuitive.

3. Visual Analog Scale (VAS)

• How it works: A 10 cm line with endpoints labeled “no pain” and “worst pain.” Patients mark a point on the line.
• Best for: Literate adults who can understand abstract scales.
• Pros: Provides a continuous measure of pain intensity.

4. FLACC Scale (Face, Legs, Activity, Cry, Consolability)

• How it works: Observational tool scoring five behaviors from 0–2 each (total score 0–10).
• Best for: Infants and non-verbal children (2 months to 7 years).
• Pros: Objective and behavior-based.

5. PAINAD (Pain Assessment in Advanced Dementia)

• How it works: Observes five domains (breathing, vocalization, facial expression, body language, consolability).
• Best for: Patients with advanced dementia or severe cognitive impairment.
• Pros: Tailored for non-verbal adults.

6. Behavioral Pain Scale (BPS)

• How it works: Scores facial expression, upper limb movement, and compliance with ventilation (0–12).
• Best for: Intubated, non-communicative ICU patients.
• Pros: Used in critical care settings.

7. McGill Pain Questionnaire (MPQ)

• How it works: Patients choose words that describe their pain (e.g., throbbing, stabbing, burning).
• Best for: Chronic pain assessment and research.
• Pros: Captures qualitative aspects of pain.

8. Defense and Veterans Pain Rating Scale (DVPRS)

• Pros: Holistic and function-focused.k at this method, we have a whole post dedicated to the PQRST method.
• How it works: Combines numeric scale with facial expressions, color coding, and functional impact.
• Best for: Military and veteran populations.

What Does PQRST Stand For?

PQRST is a pain assessment method that stands for:

• Provocation or palliation
• Quality
• Region or radiation
• Severity
• Timing

First Aid for Pain

Pain is a subjective sensation that alerts you to an injury or a potential problem in your body. Here are some general guidelines to help you manage pain on your own until you can consult a professional:

1. Assess the Situation and Identify the Cause

• Determine the Source: Evaluate what’s causing the pain. Is it due to a minor injury, a burn, muscle strain, or something more concerning? If the pain comes on suddenly or is severe, it may signal a more serious problem.
• Check for Associated Symptoms: Look for signs like swelling, redness, or decreased function in an area. If pain is accompanied by symptoms such as difficulty breathing, sharp or unusual pain, loss of sensation, or if it limits your movement, seek medical help immediately.
• Consider the Duration: If the pain is new and mild, simple first aid measures may be appropriate. However, persistent or worsening pain needs professional evaluation.

2. Provide Immediate Comfort

• Rest the Affected Area: If the pain relates to an injury or strain, rest the area and avoid activities that could worsen the situation.
• Positioning: Encourage a comfortable position that minimizes stress on the painful part. For example, if you have back pain, lying down on a supportive surface might help relieve pressure.
• Environment: Create a calm atmosphere. Stress and anxiety can amplify pain perception, so taking slow, deep breaths or using relaxation techniques may help decrease discomfort.

3. Localized Pain Relief Techniques

Depending on the nature and location of the pain, you can consider these supportive measures:

• Cold Therapy:
  • Use a Cold Compress or Ice Pack: Wrap an ice pack or a bag of frozen vegetables in a cloth and apply to the affected area for 15–20 minutes.
  • When to Use: Cold is especially effective for acute injuries, swelling, and inflammation (like a bruise, sprain, or muscle strain).
  • Caution: Do not apply ice directly to your skin.
• Heat Therapy:
  • Warm Compress or Heating Pad: For muscle soreness or chronic pain (e.g., stiff neck or lower back pain), applying heat can help relax tight muscles and increase blood flow.
  • When to Use: Use heat only after the initial swelling has gone down or for chronic, non-inflammatory pain.
  • Caution: Avoid overheating; use a moderate temperature for about 15–20 minutes.
• Gentle Massage:
  • Massaging the area may help reduce muscle tension and improve circulation. Make sure to massage gently and stop if the pain increases.

4. Over-the-Counter Medications

• Pain Relievers: Medications such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or aspirin can help reduce mild to moderate pain.
• Guidelines:
  • Follow the dosage instructions on the label.
  • Consider any pre-existing conditions or allergies before taking medications.
  • These medications address symptoms, not the underlying cause, so persistent pain still requires medical evaluation.

5. Maintain Hydration and Nutrition

• Hydration: Drinking water or herbal teas can sometimes help, especially if the pain is related to conditions like headaches, where dehydration might be a trigger.
• Balanced Diet: Ensure you’re getting proper nutrients, as deficiencies can sometimes contribute to muscle cramps or other pain issues.

6. Know When to Seek Professional Help

• Persistent or Severe Pain: If the pain continues for more than a few days, worsens in intensity, or limits your ability to function, see a healthcare provider for a proper diagnosis.
• Emergencies: Seek immediate medical attention if pain is accompanied by symptoms such as chest pain, shortness of breath, sudden confusion, or any signs that may indicate a serious injury or medical condition.

7. Pain Assessment and Management

While “first aid” measures can offer temporary relief, real pain management involves assessing factors like:

• Pain Intensity: Some healthcare providers use scales (0 to 10) to gauge how severe the pain is and plan treatment accordingly.
• Location and Quality of Pain: Descriptions (throbbing, stabbing, burning) can help determine the nature of the pain.
• History and Triggers: Knowing what worsens or alleviates the pain is useful for both immediate care and advice from a doctor.

Do’s and Don’ts

By combining systematic pain assessment, targeted first‐aid measures, and timely escalation, you help alleviate suffering and guide individuals safely toward definitive treatment.

Prevention

Preventing pain especially chronic pain is a proactive, multidisciplinary effort that blends clinical strategies, lifestyle choices, and public health interventions. Here’s a structured guide to the prevention of pain across different levels

1. Primary Prevention

Avoiding pin before it starts

• Ergonomics & Body Mechanics:
  Promote proper posture, lifting techniques, and workstation setup to prevent musculoskeletal pain.
• Injury Prevention:
  Use protective gear, safe driving practices, and fall prevention strategies.
• Vaccination & Infection Control:
  Prevent infections that can lead to painful complications (e.g., shingles, meningitis).
• Healthy Lifestyle:

• Regular physical activity (e.g., stretching, strength training)
• Balanced diet rich in anti-inflammatory nutrients
• Adequate sleep and stress management

2. Secondary Prevention

Early detection and intervention to stop pain from becoming chronic

• Timely Treatment of Acute Pain:
  Address injuries, surgeries, or illnesses promptly to prevent central sensitization.
• Education & Self-Management:
  Teach patients about pain mechanisms, pacing, and safe movement.
• Psychological Support:
  Screen for anxiety, depression, or catastrophizing that can amplify pain perception.
• Multimodal Pain Management:
  Combine pharmacologic, physical, and behavioral therapies early in care.

3. Tertiary Prevention

Minimizing disability and improving quality of life in those with chronic pain

• Rehabilitation Programs:
  Interdisciplinary approaches (e.g., physical therapy, occupational therapy, CBT)
• Assistive Devices & Modifications:
  Braces, orthotics, or home adaptations to reduce strain and flare-ups
• Vocational Support:
  Help patients return to work or adapt roles to reduce pain triggers
• Peer Support & Advocacy:
  Empower patients through support groups and pain education networks

REFERENCES

1. John Furst. First Aid for Pain: Pain Assessment and Management. First Aid for Free. February 3, 2023. https://www.firstaidforfree.com/a-guide-to-pain-assessment-and-management/
2. Firstaidcoursestasmania, A Guide to Pain Management for Adults, https://firstaidcoursestasmania.com.au/blog/a-guide-to-pain-management-for-adults/

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