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The evaluation of pain in the chronic pain patient must be multidisciplinary.

The objectives of the psychological evaluation are not to determine whether the patient's pain is "real" or "imagined," but rather is multifactorial. The standard evaluation protocol of most pain centers is the pain questionnaire, the clinical interview, pain assessment measures, and a psychological evaluation. One of the more common uses of the psychological evaluation has been to determine the appropriateness of a potential candidate for chronic opioid therapy, implantation of a spinal cord stimulator or implantable pump.

As important as the psychological assessment of the chronic pain patient is in general, it takes on added significance with the patient who presents with a history of past or present substance abuse. One of the controversial issues in chronic pain management today is whether every chronic pain patient who is being treated should first receive a psychological evaluation.

Better, more individualized assessment of pain patients, particularly those with comorbid psychiatric issues, will lead to more effective treatment of this very difficult to treat population.

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