[Pain specialist in the assessment process]

Pain specialists are often involved in assessing social medical aspects of chronic pain patients. A standardized examination in the assessment process is not published. Data and statements on the assessment process between 1993 and 1997 were recorded from 15 experts by questionnaire. Statements to 568 reports were made. The majority of performance impairments were caused by back pain (35.9%) and headache (19.3%). All examiners integrated a psychological assessment. Although the assessment processes were very different, all examiners fulfilled the minimal criteria of the presented process for assessment of chronic pain patients. Verifying the symptoms as well as capturing some aspects of aggravation proved to be problematic. The present assessment practice is discussed with regard to the unequal procedure. On basis of the received data and the own experience in examination the process of structured assessment of chronic pain patients is presented under medical and psychological aspects. It contains a recommendation of a standardized process with minimal criteria and an optional supplement of the standardized process with problematical patients (e.g.demonstration, aggravation, simulation). Minimal demands on a qualified assessment of chronic pain patients should contain the study of the history, the German Pain-Questionnaire, the analysis of all the painful complaints with weighting their importance, the examination and the basic registration of sensational, emotional, cognitive, behavioral and social aspects of the chronic pain syndrome. An appended glossary of the most usable psychological tests with comments on their validation criteria aims to provide a more standard multimodal assessment of chronic pain patients complaints and functionability.