Pain is a multifaceted experience and any assessment of it must consider the impact of the pain on the sufferer. Chronic pain is more than a persistent acutely painful condition: it is a condition in which a degree of physiological and psychological maladaptation may occur. Prevention of chronicity is a goal of modern acute pain management, but it is not enough to assume that a simple one-dimensional physical assessment and pharmacological treatment will achieve this. Even in the acute setting it is possible to be aware of presentations that are indicators that a patient is at risk of developing chronic pain. To understand this it is necessary to consider that there are five dimensions to the experience of pain:
• Sensation of pain. • Suffering and distress: the affective dimension. • Expectations and beliefs: the cognitive dimension. • Complaints and non-verbal communication: the behavioural dimension. • Impact on the patient of the social environment.