Identifying the source of pain can be a difficult and long process.  Sometimes pain is not a symptom of a problem; it is the problem. 

We usually think of pain as a bad thing.  But pain is also a good thing when it warns us that something's wrong.  We need the sensation of pain to tell us to take our finger from a hot stove or that we have an infection and should go to a doctor.

When pain is no longer useful as a warning, when it continues past the time of recovery or when it occurs for no discernable reason over an extended time period it becomes chronic pain.  Chronic pain can be a symptom of a problem, or it can be the problem itself – basically a disease like any other.

As with any disease, understanding chronic pain is the first step toward managing it.  Unfortunately, many cases of chronic pain don't correlate to an obvious source.  That makes it challenging – and even frustrating – for doctors to diagnose. 

While testing can be done to attempt to find the cause of pain, there is no lab test, x-ray, or scan to prove the existence or intensity of pain.  Pain is what the patient says it is. But, describing pain in words can be difficult. When you feel pain, your brain is receiving a complex mixture of signals. Pain receptors and nerve pathways differ throughout the body and, consequently, the sensation of pain differs depending on where the message comes from and how it travels.

Each person experiences pain differently.  People with similar problems may feel different levels of pain. They also differ in their ability to tolerate pain and how they respond to pain medication.  There are a number of influences that make the experience vary among individuals, including:

• Previous experience with pain
• Physical differences
• Personality and mood
• Attitude and expectations

Doctors usually take an extensive medical history and perform both a physical examination and pain assessment to diagnose pain.  They try to determine the intensity of the pain and what's causing the pain by asking questions such as:

• Where is it?
• Where does it go?
• What does it feel like?
• When did it start?
• How did it start?
• What makes it better?
• What makes it worse?
• When is it the most bothersome?
• Does it come and go or remain constant?
• How bad is this pain compared to other pain that you've had?
• How does the pain affect your ability to function?
• What medications or treatments have you tried for the pain?

Doctors also use a variety of pain intensity scales to measure how severely individuals are feeling pain and to monitor the effectiveness of treatments.

Sometimes it takes a long time to get to the bottom of a chronic pain problem.  Both the doctor and the patient have to be persistent and the doctor must provide positive support and interim treatment for the pain and its side effects (such as depression and sleep disorders) for the patient along the way.