Pain: The Fifth Vital Sign
A medical visit includes essential measurements, height, weight and the so-called "vital signs," blood pressure, pulse, respiratory rate and temperature, which give an indication of health status. Lately, many medical practitioners have added another indicator, pain assessment, what some call the "fifth vital sign."
Since pain cannot be measured objectively, the patient is asked to rate any pain at the time of the visit on a scale from zero to 10. Children use a scale based on faces from a smile for no pain to a crying face to show how they feel. If blood pressure were never measured, physicians would be less able to identify those who need treatment. Similarly, with pain, if no one assesses it, many with pain will go untreated.
Pain can arise from injury to body structures through trauma, such as a fracture or burn or as a result of surgery or as a complication of disease, such as cancer, HIV, diabetes nerve damage, infection, arthritis and toxins. The causes of some pain syndromes are not well understood as in the case of complex regional pain syndrome, formerly called causalgia or reflex sympathetic dystrophy.
According to a 1999 Gallup survey, nine in 10 Americans regularly suffer from pain. Untreated, pain can lead to other medical complications depending on the cause of the pain. Pain causes long-term disability, short-term job absences and contributes to depression. Pain is often under treated for a variety of reasons. People with pain may not report it and doctors may not diagnose it or feel comfortable with treatment options.