ABSTRACT
BACKGROUND: Traditional pain assessment instruments are subjective in nature. They are limited to subjective reporting of the presence and magnitude of pain. There is no means of validating their response or assessing their pain tolerance. The objective of this study was to determine the potential value of a novel addition to the traditional physical examination concerning a patient's pain and more importantly their pain tolerance. METHODS: Extensive preliminary data were collected on 359 consecutive private practice knee patients referable the subject's pain, including the magnitude, the most pain ever experienced, and their opinion of personal pain tolerance. The novel evaluation included physical testing of a series of small ball drops through a vertical tube from various fixed levels on the index finger and patella. The patient's response to this impact testing provided quantitative information, from which a comparison was made to their pain opinion and also to that of other patients with similar demographics. RESULTS: Nine percent of the patients rated their pain tolerance below the midpoint on the visual analog scale. Seventy-one percent thought they were above the midpoint on the scale in regards to pain tolerance. There were discrepancies in both directions between the subject's opinion on pain tolerance and their rating of their pain experience to the ball drop testing. Twenty-eight percent of the entire patient group rated themselves above 5 on tolerance, but experienced above the average discomfort compared to other subjects reporting on the finger impact testing. CONCLUSIONS: This report introduces a novel method for collecting data concerning pain that can be subjected to quantification. The database included quantitative measures providing the opportunity to confirm, validate or refute the patient's assertions concerning pain magnitude and tolerance. This method is best described as a patient pain profile. It has the potential to give both the patient and the physician quantified objective information rendering insight not otherwise available.
