C2 · Long-lasting pain
Actual Comfort and rest
Definition
Pain that continues for months or longer and affects daily life and mood.- Arthritis
- nerve injury
- cancer
- back problems
- Pain for months
- poor sleep
- low mood
- limited activity
📋 Scenario
A man with back pain for three years avoids walking and sleeps poorly.
Subjective (S): "My back hurts every day and I can't do anything."
Objective (O): Pain 6/10 for 3 years; guarded posture; avoids walking; sleeps 4 hours; low mood noted.
Assessment tools for this scenario: CP-PAIN Pain & Comfort Score
Validated scales to consider: NRS 0–10, FLACC, PAINAD
**CarePath diagnosis:** Long-lasting pain related to arthritis, as evidenced by pain for months and poor sleep.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Assess pain and its effect on life. | Long-lasting pain affects sleep, mood and activity, so assessing both pain and its effect on life shows which goals matter to the patient. |
| Give regular medicines as ordered. | Regular scheduled medicines keep pain control steady, which works better than waiting until pain becomes severe. |
| Teach pacing, gentle exercise, and relaxation. | Pacing, gentle exercise and relaxation keep joints and muscles moving, reduce fear of movement and lower the tension that adds to pain. |
| Support mood. | Low mood and long-lasting pain feed each other, so emotional support can improve coping, sleep and willingness to be active. |
**Expected outcomes**
- Over 4 weeks: pain score down by at least 2 points, walks short distances daily, sleeps 6 hours.
- Patient uses 2 coping methods.
**Linking the data to the diagnosis**
The man has had back pain for three years, now 6/10, and says his back hurts every day and he cannot do anything. He avoids walking, sleeps 4 hours, has a guarded posture and low mood. Pain lasting years that disturbs sleep, activity and mood fits long-lasting pain rather than short-term pain, which is recent and expected to settle. The problem is present, so this is an actual diagnosis. The plan aims over 4 weeks to lower the pain score by at least 2 points, restore short daily walks, raise sleep to 6 hours, and give the patient 2 coping methods.
CarePath diagnosis
Long-lasting pain related to arthritis, as evidenced by pain for months and poor sleep.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Assess pain and its effect on life. | Long-lasting pain affects sleep, mood and activity, so assessing both pain and its effect on life shows which goals matter to the patient. |
| 2. Give regular medicines as ordered. | Regular scheduled medicines keep pain control steady, which works better than waiting until pain becomes severe. |
| 3. Teach pacing, gentle exercise, and relaxation. | Pacing, gentle exercise and relaxation keep joints and muscles moving, reduce fear of movement and lower the tension that adds to pain. |
| 4. Support mood. | Low mood and long-lasting pain feed each other, so emotional support can improve coping, sleep and willingness to be active. |
Expected outcomes
- Over 4 weeks: pain score down by at least 2 points, walks short distances daily, sleeps 6 hours.
- Patient uses 2 coping methods.
Linking the data to the diagnosis
The man has had back pain for three years, now 6/10, and says his back hurts every day and he cannot do anything. He avoids walking, sleeps 4 hours, has a guarded posture and low mood. Pain lasting years that disturbs sleep, activity and mood fits long-lasting pain rather than short-term pain, which is recent and expected to settle. The problem is present, so this is an actual diagnosis. The plan aims over 4 weeks to lower the pain score by at least 2 points, restore short daily walks, raise sleep to 6 hours, and give the patient 2 coping methods.