Purpose of review: This review highlights challenges and current trends in tools used to assess acute pain across the lifespan.
Recent findings: A plethora of similar assessment tools exist for acute pain, most focused on self-report of pain intensity. Attempts to improve the frequency and visibility of pain assessment by prompting pain as 'the fifth vital sign' resulted in unintended consequences, creating a pressing need for a conceptual shift to multidimensional assessment of acute pain.
Summary: Valid and pragmatic assessment of pain is essential for effective pain management. Unidimensional scales that capture self-reported pain intensity ratings undervalue to the complexity of the pain experience. Pain is a biopsychosocial experience and assessment is a complex social transaction and an exchange of the meaning of pain that demands a more comprehensive approach.