4. METHODS OF PAIN ASSESSMENT
Pain is a wholly subjective experience; thus, objective assessment is
hindered. Traditionally, pain has been evaluated using three main
approaches: patient self-report, behavioral observations, and
physiologic indicators. In addition, there is growing evidence for the
use of psychophysical, neurophysiological, and neuroimaging techniques
to objectively complement those assessments (Table 1). However,
accurately applying these modalities in patients with OUD requires
nuanced understanding of their respective strengths and limitations,
particularly considering the biopsychosocial and opioid-related
variables of interest.
Notably, the pain assessment tools utilized in various observational and
randomized controlled trials evaluating both acute and chronic forms of
pain in individuals with OUD are often inconsistent, as there is limited
evidence to justify the choice of one tool over another, reflecting the
need to develop consensus on optimal evaluation methods for this complex
population. Additionally, although the psychometric properties of the
assessment self-report scales have been widely
reported97-99, providing evidence of reliability and
validity, psychometric evaluation is often absent for populations of
persons with both pain and OUD.