GP pain management: what are the 'Ps' and 'As' of pain management?

Abstract

Background: Pain is one common reason for clinical encounters in primary care. The complex nature of chronic pain syndromes can make assessment and management daunting at times.

Objective: This article presents an easy scheme to help general practitioners efficiently assess, manage and review/follow up patients with chronic pain.

Discussion: The mnemonic presented for assessment is the '4Ps' (pain, other pathology/past medical history, performance/function and psychological/psychiatric status). For management, we can also use '4Ps' (physical, psychological, pharmacological and procedural) and for review there are the '6As' (activities, analgesia, adverse effects, aberrance behaviours, affects and adequate documentation).