Determining the onset and timing of pain
The circumstances surrounding the onset of pain help to identify precipitating causes of the pain such as trauma, injury or a psychosocial stressor (see Factors that aggravate pain).
The temporal pattern of pain (eg sudden or gradual onset, intermittent or continuous) can suggest a particular diagnosis. For the temporal pattern of musculoskeletal pain, see here. For the temporal pattern of headaches, see Classifying headaches.
If pain is intermittent, note its pattern, including triggers, onset and duration, and the interval between episodes.
If pain is continuous, note fluctuations or ‘flares’ and how they relate to:
- the time of day (eg worse pain at night might be due to an absence of distraction, or bony metastases)
- movement
- incidents (eg coughing, transfers or dressing changes). Pain that relates to an incident is known as ‘incident pain’.