Evidence-Based Practice in Pain Management

Instructor: Geralyn Vilar
This lesson focuses on the use of evidence based nursing practice for effective pain management. There are many types of treatments available. Included in the lesson are a few examples of the different types of treatments that can be used to alleviate pain.

Evidence Based Medicine

Have you ever had a day that began with a slight headache? Then on the way to work BAM, a traffic jam! As you realize that you will be late for work, tension mounts in your neck and your headache increases. You arrive 35 minutes late only to find out that you have to complete your own work plus the work of a sick colleague. You grab a cup of coffee and trip, spilling it on your new shirt. Now your head is pounding. You try an over the counter pain reliever, but it does not help. As you go through the rest of your day your headache increases leaving you feeling drained and wondering how you can relieve the pain. Evidence-based nursing practice to the rescue!

My head is pounding

What is Evidence Based Medicine?

Practicing evidence-based medicine means that the assessment techniques and treatments used have been proven to be effective through research. The research for pain management has shown that a combination of different types of treatments are best for maximum effectiveness. Evaluating the patient to determine the level of pain is a must for effective pain management, as is frequent re-evaluation. Pain scales, such as, the RFP (Revised Faces Pain Scale), VDS (Verbal Descriptor Scale) and NRS (Numeric Rating Scale) are used to determine the level of pain.

RFP uses different facial expressions to indicate pain. This scale is very helpful when used for children and patients who are nonverbal.


NRS is the most common pain scale. This scale uses a numbering system to rate pain.


VDS is very useful when used with adults who communicate well. This scale uses specific descriptions of pain. The patient points to the description that best identifies his/her pain. Each description has a number value. The numbers for each evaluation are added together and then divided by the number of evaluations. This gives an overall idea of the patient's level of pain.

Verbal Descriptor Scale

Patient's Name: Date:

Instructions: Please place a check mark next to the phrase that best describes the current level of your pain.

The Most Intense Pain Imaginable

Extreme Pain

Severe Pain

Moderate Pain

Mild Pain

Slight Pain

No Pain

Evidence Based Pain Management

It is very important for the patient to take an active role in his /her own care. There are many options available that are proven to effectively treat pain. Combining different modalities from conventional and alternative medicine has proven benefit. Evidence based practices can serve as a guide for patients to choose providers and treatments that work the best for them.

In conventional medicine (mainstream or western medicine), the most common treatments for the relief of pain include; prescription and non-prescription medications, relaxation techniques, cool and warm compresses, increasing fluid intake, physical therapy, TENS which stands for transcutaneous electrical nerve stimulation (where the nerves are stimulated through the skin), and electrothermal therapy.

Alternative medicine (other than mainstream or conventional medicine) can include; massage, chiropractic treatments, Reiki (channeling energy through touch), magnetic field energy, herbs, homeopathy, acupuncture and acupressure.

CAM, complementary and alternative medicine, are non-traditional or alternative types of medicine that are used along with (complimentary) or in place of (alternative) conventional western medicine.

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