Why pain should be recognised as a vital sign — and how it will help patients

Roland Watson

Chair, Pain UK (CIO)

Pain should be a vital sign. Learn why it’s crucial for healthcare to prioritise pain assessment, ensuring better patient care and comprehensive health monitoring.

Healthcare professionals routinely monitor four measurable vital signs: (1) body temperature; (2) pulse rate; (3) respiration rate (rate of breathing); and (4) blood pressure.

Assessing pain as a vital sign

Currently, pain is not considered to be ‘vital.’ It cannot be measured. Yet, in ‘UK Pain Messages 2024’, the British Pain Society states:

• Approximately 8 million adults report moderate to severely disabling pain. 
• Around 43% of adults (almost 28 million people) live with a degree of chronic pain.
• In older age groups, the rates are higher, with up to 62% of those aged 75 and over reporting chronic pain symptoms.

Pain is a critical indicator of underlying conditions.

Steps to elevate pain as a vital sign

1. Standardise assessment tools: Implement consistent, validated pain assessment tools and pain scales across all healthcare settings to ensure that pain, like other vital signs, is regularly monitored.
2. Education and training: Educate healthcare professionals on the importance of pain assessment and management, including recognising different types of pain and understanding appropriate treatment options.
3. Policy integration: Incorporate pain assessment protocols into clinical guidelines and hospital policies, making it a routine part of patient evaluations.
4. Patient-centred approach: Encourage open communication with patients about their pain, ensuring that their experiences are validated and addressed.
5. Patient-centred language:Understand that patients use a wide range of words to describe their pain. It might ‘ache,’ ‘burning’ or ‘over-sensitivity’ — and they may deny ‘pain.’
6. Regular audits and feedback: Conduct regular audits to ensure pain is being assessed and treated effectively, providing feedback and making necessary adjustments to improve care.
7. Balanced pain management: Combine pain assessment with strategies to prevent over-reliance on opioids, using a multidisciplinary approach to pain management.

Value in promoting pain awareness

Viewing pain as a vital sign encourages healthcare providers to assess pain, which improves patient care. Pain is a critical indicator of underlying conditions. Neglecting it can lead to unnecessary suffering and delayed treatment.

As a vital sign, clinicians will have to consider it as an integral part of patients’ overall health, ensuring that it is monitored and managed. This approach ensures patients — not just the condition — receive treatment.