David Blair                                                            Supervisor: Emma Chippendale

Abstract

Aims: The aim was to investigate whether pain was being successfully communicated by patients to senior students in the London School of Osteopathy during osteopathic consultations. Also, whether some aspects of pain are communicated better than others, and whether there are differences in pain communication based on gender, ethnicity, age, or duration. 

Methods: Pain questionnaires using both unidimensional and multidimensional pain measurement tools were completed by a random sample of 62 patient volunteers. Student practitioners completed an identical pain questionnaire after the consultations, which provided data to compare the communication of the key aspects of pain.

Results: Results indicate that there is a significant difference between self-reported pain by patients, and that recorded by practitioners. The study also shows that practitioners on average underestimate patient’s pain in osteopathic consultations by 8% - 48%, depending on the pain measurement tool used. Using the McGill Pain Questionnaire short form, only 13% of the affective component is communicated, compared to 52% of the sensory component, and 44% of the overall pain component. Simple unidimensional pain tools are very effective in communicating pain intensity especially the Visual Analogue Scale (VAS) with 92% agreement. Women communicate their pain better than men, but no differences were found in pain communication based on age, or duration of pain.

Conclusions: Pain is not well communicated in osteopathic consultations and especially the affective aspects of pain. The use of simple unidimensional pain measurement tools in osteopathic practice, can significantly improve pain communication, which can improve osteopathic diagnosis and management.