The Pain Process

Pain Assessment: The WILDA process

A patient’s knowledge and beliefs about pain can play a role in their perception of pain and how it affects them. Many are very reluctant to go to their doctor; some to save money and others just look at it as a hassle. They tell themselves that “the pain will go away eventually.” But there are others who run to their doctors at an inkling of a strange feeling. When you do go to your doctor’s office, you might have noticed that their first protocol is to ask questions to decipher and diagnose the issue. When it comes to pain, a pain assessments are crucial for pain management and finding the most optimum way of curing it. Pain is very subjective and can be very broad but the WILDA approach provides a concise template for assessment. It focuses on words for pain description, its intensity, location, duration and aggravation.

Pain is defined as an unpleasant sensory and emotional experience from tissue damage by the International Association of the Study of Pain. It can be thought of as a part of life; it can occur to anyone at any age. There are two types of pains. The first is acute pain which can last anywhere between hours to weeks. It is caused from tissue damage, inflammation, during a surgical recovery process, or temporary disease. Chronic pain, on the other hand, intensifies over time and can last for months or even a lifetime. They are even types of pain that are side effects to diseases like cancer, arthritis, fibromyalgia, diabetes or unresolved injuries.

The physician usually starts off by asking you to tell them about your pain. This starts off the WILDA process as you describe the pain. Then the doctors go on to ask how much it hurts, where it hurts, how long it’s hurting and if there is anything that intensifies or alleviates the pain. They may also ask how it feels to gain more description. Some common pains that patients tend to describe are neuropathic pain which feels like a burning or shooting pain, somatic pain which achy throbbing pain or visceral pain which feels like pressure or cramping.

Doctors also use a pain scales from numbers 0 for no pain to 10 being severe pain to describe intensities of pain. For children, they tend to use a visual pain scale like The Wong/Baker face rating scale which contains corresponding face expressions with each number to aid them with identifying their pain. Doctors may also ask patients the intensity of pain over a period of 24 hours, when it hurts the most and when the least and if the pain continues, patients are provided with pain medication.

There are many approaches to alleviating pain. Doctors will ask if you have noticed how or when the pain better or worsens. From there, the doctor can decide what approach to take. There are pharmaceutical and no pharmaceutical approaches. Pharmaceutical is using drugs like Advil to alleviate the pain, and no pharmaceutical are massage or therapy approaches. The doctor will also ask about previous health issues like depression, constipation, insomnia or nausea which can also be a factor in intense pain.

Whether you are familiar with medical terms and symptoms, the WILDA approach can be used at home to provide you, the patient, a checklist that will help you gain more information about your pain that you may have overlooked and potentially save more time at hospitals when consulting your doctor.






Walida Ali