Have you ever found yourself nodding along, even saying “Yes!” out loud, while reading something? That was me yesterday, reading an article in The Independent; a newspaper published in the United Kingdom.
The author was reporting on pain, after his wife had suffered a bout of pancreatitis. He found it odd that she was asked to rate her pain in a seemingly artificial and counterintuitive way, so he decided to look into measurements of pain.
Some examples of pain scales currently used by physicians are the 0–10 Numeric Pain Rating Scale, the McGill Pain Index (MPI), the Pain Quality Assessment Scale (PQAS), and the Wong-Baker FACES Pain Rating Scale. I’ve included a link to excerpts of these in the references, at the end of this post.(1) There are, however, many other versions of pain scales; longer, shorter, ever parody versions.
What I found myself yelling “Yesss!!!!” to, in this article, were several quotes from pain researchers and specialists. Luckily I was reading the article at home, not at the office or in a public place – otherwise folks would have thought I was having a conversation with myself ‘-)
First off, I’m going to say that you should really go read the entire article. It’s available, at no cost, at: https://www.independent.co.uk/life-style/health-and-families/pain-how-much-does-it-hurt-pancreatitus-methods-doctors-measure-a7513101.html
The specific quotes that had me literally yelling out loud were these. Let me know whether you also find yourself nodding along, or even talking out loud in response to them!
Professor Stephen McMahon of the London Pain Consortium, an organisation formed in 2002 to promote internationally competitive research into pain.
“There are lots of problems that come with trying to measure pain,” he says.
“I think the obsession with numbers is an oversimplification.
Pain is not unidimensional.
It doesn’t just come with scale – a lot or a little – it comes with other baggage: how threatening it is, how emotionally disturbing, how it affects your ability to concentrate.
The measuring obsession probably comes from the regulators who think that, to understand drugs, you have to show efficacy.
And the American Food and Drug Administration don’t like quality-of-life assessments; they like hard numbers.
So we’re thrown back on giving it a number and scoring it.
It’s a bit of a wasted exercise because it’s only one dimension of pain that we’re capturing”.”(2)
The greatest recent breakthrough in assessing pain, according to Professor Irene Tracey, head of the University of Oxford’s Nuffield Department of Clinical Neurosciences, has been the understanding that chronic pain is a thing in its own right.
She explains: “We always thought of it as acute pain that just goes on and on – and if chronic pain is just a continuation of acute pain, let’s fix the thing that caused the acute and the chronic should go away. That has spectacularly failed.
Now we think of chronic pain as a shift to another place, with different mechanisms, such as changes in genetic expression, chemical release, neurophysiology and wiring.
We’ve got all these completely new ways of thinking about chronic pain.
That’s the paradigm shift in the pain field.”(2)
This journalist also noted that the distinction between acute and chronic isn’t based on the severity of the pain, but rather on its duration. That’s something that I find myself explaining to colleagues and others on an almost-daily basis, since having been diagnosed in late May of last year with a rare neuro-inflammatory disease that causes severe neuropathic pain:
“Acute” pain means a temporary or one-off feeling of discomfort, which is usually treated with drugs; “chronic” pain persists over time and has to be lived with as a malevolent everyday companion.”(2)
As always, thanks for reading! If any of these excerpts resonated with you, please go read the article; it’s worth your time.
And I’d like to take this opportunity to wish you a very Happy New Year – to you and your loved ones; whether family or friends.
I wish you many moments of joy, in each day of 2017!
References:
(1) Various authors and sources. Pain Assessment Scales. Published as a set, by the National Initiative on Pain Control (NIPC). Undated. PDF. 2003. Accessed 11 Jan 2017. Web:
https://www.maineddc.org/images/PDFs/Pain_Assessment_Scales.pdf
(2) John Walsh. How much does it hurt?: The methods used by doctors to measure pain. The Independent. 10 Jan 2017. Online. Accessed 11 Jan 2017. Web:
https://www.independent.co.uk/life-style/health-and-families/pain-how-much-does-it-hurt-pancreatitus-methods-doctors-measure-a7513101.html