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The Arbitrary Pain Scale: Here's What It Means to Doctors

March 31, 2023
The Arbitrary Pain Scale Here's What It Means to Doctors

Are you a chronic pain patient who often feels frustrated by the arbitrary pain scale doctors use to measure your discomfort? If so, you are in good company. Doctors feel the same frustrations from time to time. The unfortunate truth is that there is no scientific way to accurately measure pain. Still, a pain scale that may seem arbitrary to patients does mean something to doctors.

If you have no idea what we are referring to, pain management doctors regularly ask their patients to rate their level of pain on a scale of 1 to 10. We even have a graphic image featuring six emoticons – complete with facial expressions – to help patients make sense of the pain scale.

In a recent post published by Psychology Today, chronic pain patient and contributor Jen Sarché, MPH discussed both the pain scale and its accompanying graphic in terms that weren't very favorable. The truth be told, it's hard to argue with her assessment.

Pain Is a Personal Thing

Sarché laid bare a fundamental truth every chronic pain patient knows – pain is a very personal thing. No two people experience it the same way. This is what makes the pain scale so frustrating to patients. Trying to rate their pain on a numerical scale is exceedingly difficult in light of the fact that they have no baseline.

Not only that, but the pain experience can also change on a daily basis. Things are made even worse when patients have to deal with multiple conditions that contribute to different kinds of pain. It all becomes an overwhelming mishmash of pain and the emotions that come with it.

What It Means to Doctors

We pain management doctors have great empathy for our patients. Our greatest desire is to offer some measure of relief. In order to do that, we need to have some idea of how a patient feels – both physically and mentally/emotionally. That's why we rely so heavily on the pain scale and its numeric rating system.

We don't hold to any fantasies that the pain scale is a scientifically accurate measurement of physical pain. But it does help us interpret where a patient is at any given time. For example, if you were to rate your current level of pain at 10, that tells your doctor that you cannot imagine things getting any worse. They know that you have reached your limit and you are looking for literally anything that will help.

It doesn't so much matter if your pain isn't really that intense (provided there were a scientific way to actually measure it). All that matters is your perception. You feel it is at 10 so that's what it is. Now your doctor knows how to respond.

It's a Communication Tool

If it helps you feel better about the pain scale, think of it as a communication tool rather than a diagnostic tool. You already know that the pain scale isn't in the same league as an MRI or CT scan. No doctor can look at the results of your pain rating and figure out what's causing you to feel the way you do. Instead, the pain scale is a way for you to communicate your current level of discomfort in a comprehensible way.

Chronic pain patients often find themselves frustrated when asked to rate their pain on a 10-point scaled. That is understandable. We pain doctors get it. But the pain scale is designed to help us understand how you feel so we can respond accordingly. Despite your frustrations with the scale, humor us. It helps us help you.

By KindlyMD
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