Prioritizing Assessment of Postoperative Movement-Evoked Pain
It hurts to move.
It’s 10:00, 15 hours postoperative, and your patient has eaten breakfast and is resting comfortably in bed. You ask the patient, “On a scale of zero to 10, how much pain are you having right now?” The patient replies “zero, as long as I don’t move.” The nurse documents the pain score as 0/10 and continues their rounds.
Most nurses are happy when patients report no pain. What is the nurse missing? The contextual factor called movement.
Several years ago, a research participant told me, “Ain’t no sense in getting up to hurt.” A very simple yet powerful statement began my quest to shift how we understand and assess the dynamics between pain and movement.
The realities are:
- Movement increases acute pain postoperatively, and most patients are afraid to move even when the importance of ambulation is known.
- Most patients need some type of pain medication or non-pharmacological intervention to engage in mobility-related activities.
- Movement and mobility enhance recovery and rehabilitation.
- Movement-evoked pain is as a major barrier to participating in activity-based interventions.
Movement-evoked pain is an important pain characteristic that describes pain and discomfort during active or passive motion of the affected area. Yet, despite awareness among nurses of the importance of setting function-related pain goals, most of our pain assessments are performed […]