What is the PQRST Pain Assessment Method?

Before the physician can properly diagnose or treat you, it is helpful to formulate into words an explanation of what you believe the problem is. This allows the physician to better understand the situation you are in. Unsurprisingly, this also applies to individuals who are dealing with pain. However, there are several instances where patients have a hard time being able to detail what exactly the problem is, especially considering how different pain is for each person. This is where the PQRST Pain Assessment Method comes into play. The PQRST pain assessment method is, as the name implies, a way for patients to be able to describe and assess the amount of pain they are experiencing. PQRST is an acronym, with each letter asking various questions related to the patient’s pain. Each letter will be explained in further detail in the following paragraphs.

The “P” in PQRST stands for “Provocation or Palliation.” This letter is aimed toward finding the origin and cause of the pain. Questions that can be asked are, “What actions were you performing that might have triggered the pain?” or “What actions cause the pain to become worse?” Stretching, sitting down, or bending over can be some activities that cause the pain to worsen. In addition, it can also focus on actions that might actually help relieve the pain. The next letter,  “Q”, stands for “Quality or Quantity.” This letter helps to better describe the pain. A specific question that can be asked is “What are you feeling?” There are various types of pain that can be felt, including but not limited to a burning, throbbing, or stabbing sensation. It is best to try to be as specific as possible. The “R” stands for “Region or Radiation.” This letter tackles the region in which the patient is feeling the pain. Pain can also often radiate, or travel, through various other regions. For example, it is not uncommon to feel a pain on the shoulder that then travels through the arm and fingers. It is also good to specify whether or not the pain originally started in one location but then over time began to go to other parts of the body. 

The second to last letter, “S”, stands for “Severity Scale.” Physicians may ask, on a scale of one to ten, with zero being virtually no pain and ten being the worst, how would the patient rate their pain? It is also helpful to know how much does the pain hinder the patient’s day to day activities. This also helps the physician decide on how quickly treatment must be given, especially if the patient is in horrible pain that halts them from doing even basic actions.  Although pain is subjective, this rating can still provide some insight. Finally, The “T” stands for “Timing.” Some common questions associated with this letter are, “At what time of day does the pain usually begin?”, “How long does the pain last for?” or “Does it affect your sleep schedule?” Sometimes, there is another letter at the end of the acronym, making it “PQRST-U.” The “U” represents the question of, “What do you (the patient) think the issue is?” This can be essential as it is the patient who is the one who knows their pain the best.

Although these questions seem like something that a patient dealing with pain would think about, it is still helpful to have it as a collective form of questions, as it can help the patient be more specific in the pain they are experiencing. The use of the PQRST Pain Assessment Method can help physicians better identify the issue and thus, help potentially find the best treatment for the patient. Even after potential treatment that the physician has prescribed, these questions may still be asked until the pain has gone away or has gone down to manageable levels. 

References:

http://www.crozerkeystone.org/healthcare-professionals/nursing/pqrst-pain-assessment-method/ 

https://www.studyblue.com/notes/note/n/pqrst-u-assessment-acronym/deck/5342079 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031188/ 

Cherry Lam