Are Your Service Users Suffering in Silence?

Pain management is an area that all staff working in social care settings will encounter at some point. Service users may suffer chronic or acute pain, or even a combination of both, so it is important that your staff understand their role in detecting and treating pain effectively.

Untreated pain can lead to irritability, depression, reduced independence and can have a significant impact on the quality of life of the sufferer. Often, analgesia is prescribed but little attempt is made to monitor the effectiveness and, worse still, in some cases where service users are unable to verbalise their discomfort, pain may go undetected and untreated – leading to prolonged suffering.

Taking positive steps to ensure your staff have a clear understanding of their responsibilities, in relation to pain management, can bring great benefits to the quality of life of your service users. Read on to find out more about the measures you can take to improve the management of pain within your service.

Service users will often be reluctant or unable to report pain but, by observing for common signs of pain, your staff may be able to identify those service users who are suffering in silence. The signs of pain are frequently described as either behavioural or physiological:


  • Agitation
  • Restlessness
  • Verbalisation (crying out, sobbing)
  • Changed facial expression (grimacing or frowning)
  • Rocking or writhing
  • Changed posture (curled up or guarding an area).


  • Increased heart/respiratory rate
  • Increased blood pressure
  • Nausea/vomiting
  • Pallor
  • Sweating.

4 Key Points of Successful Pain Management

  1. Types of pain. Pain can be acute or chronic in nature and can vary in frequency and intensity. Understanding the different types of pain a service user may be experiencing will help your staff to detect if this is a new pain, or an exacerbation of an existing problem.
  2. Pain assessments. Pain assessment tools, such as the Abbey Pain Scale, should be used to help ascertain the most appropriate treatment and monitor the potential causes of the pain being experienced. The more information available, the more successful any treatment is likely to be.
  3. Measuring pain. Service users who are reluctant to report pain may need to be encouraged to report the type and severity being experienced. Staff should routinely ask service users if they have any discomfort, rather than expecting the service user to take the initiative.
  4. Monitoring effectiveness. The effectiveness of any intervention should be monitored and recorded, to help assess the potential benefits or otherwise. Once a treatment has been established, it should continue to be monitored to ensure it remains effective if the severity of the pain increases.

Pain management is a regular topic in Care Quality Matters. Every month, we provide best practice advice for care managers – to help make sure you pass your CQC inspections while giving the best standards of care to service users. To learn more about Care Quality Matters, click here.

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