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When managing a patient in extreme pain, the initial approach of evaluating their medical history and current pain level is crucial for several reasons. Understanding the patient's medical background helps the physician identify any underlying conditions or previous treatments that might influence pain management.

Additionally, assessing the current pain level allows the physician to gauge the severity and nature of the pain, which is essential for determining the most appropriate treatment. It facilitates a comprehensive understanding of the patient’s situation, enabling the physician to make informed decisions regarding potential interventions, including the type and dosage of pain relief, and to consider any other factors that may affect the patient's well-being.

This thorough evaluation process ensures that management is tailored to the individual's specific needs rather than making assumptions or jumping straight to medication, which may not address the root cause of the pain or may pose risks based on the patient’s medical history.