There are different types of pain: • acute pain starts suddenly and is short-term

Clinicians commonly evaluate patients for the cause of chronic pain but do not always diagnose the type of pain. The pathophysiology of pain, if accurately determined, can help in the selection of appropriate treatment.

Treat and assess pain as an uninvited guest. Find what makes it quiet and compliant. Note that if you fight it, pain will always win.

It is important to note and consider the fact that pain has many “strengths” that can lead to serious musculoskeletal deconditioning and dysfunction depending on its acuity with the net result of a decreased quality of life.

Management of goals and objectives for successful pain management should be done by clarifying the objectives and efforts and using the resources productively.

Injury or major complaint: Progressive bilateral shoulder pain over 2-3 months. No specific mechanism of injury. Job description includes lifting of heavy boxes and general maintenance and cleaning with use of mops.

Injury or major complaint: Complains of progressive nagging bilateral knee pain present over 6 months. Pain is present at rest and worse with increased activity and cycling. The doctors have diagnosed Robert with bilateral knee arthritis in the past.

Injury or major complaint: Michele was running training for a 5 km run and accidentally twisted right ankle. She felt pain on the outside of her right ankle and developed swelling and had difficulty walking. She did not feel it was serious enough to have X-rays and understood that it was just a sprain. She went home and followed the principles of ice, compression and elevation. Product used: Topical analgesia and ace bandage but with minimal relief

Injury or major complaint: Leo was playing soccer and was hit by the opposing player and landed on his L knee. He felt pain and his knee began to swell. It has been a week and Leo’s knee remains swollen and painful. He has been unable to practice with his team. He was seen by the team physician and was diagnosed with a knee bruise and small sprain

Injury or major complaint: Progressive bilateral shoulder and upper back pain over 2-3 years. No specific mechanism of injury. The pain is affecting quality of life. Lucas has a hard time getting active or even remaining active.

njury or major complaint: Complains of R lateral elbow pain at rest and when carrying objects. Pain is progressive and elbow movement is limited because of the arthritis. No specific trauma. Doctor says it is just wear and tear over the years.

Injury or major complaint: Benny went shopping to do the groceries and slipped but did not fall. She was unable to walk comfortably because of pain in her left calf. The doctor said she had a small calf muscle strain and that it would get better.