We use scales in our office when we assess our patients. These aren’t the types of scales that tell us about someone’s weight, but rather they are scales to help describe a patient’s level of pain. There are pain scales that identify neck pain disability, back pain disability and numerous other pain rating scales that are scientifically valid measures of a patient’s level of discomfort.
The most simple and common pain scale is one that measures zero through 10, where zero represents no pain whatsoever and 10 is the worst possible pain. After I welcome a new patient to our office, one of the first things I do is look at the paperwork they kindly filled out in the waiting room. I almost always go straight to where they filled in the pain scale.
Pain scales intrigue me because of how widely different they can be filled out among those who describe similar injuries. Why is it that someone can hit their thumb with a hammer and rate their pain as a four out of 10, yet another person hits their thumb with the same force yet calls it a nine out of 10?
Pain is not just a physical reaction to a physical trauma. There is a large emotional component to how one experiences pain. The Canadian Pain Task Force (CPTF), in their June 2019 report, recognizes the World Health Organization’s classification system for pain assessment to take into account emotional distress.
Psychologically, pain, especially chronic pain, has been linked to depression, anxiety and even helplessness. The CPTF also emphasizes the significant social consequences of chronic pain such as withdrawal from relationships, stigma, and criticism.
Pain not only affects one’s emotions — a person’s emotional and psychological well-being affects how a person experiences pain as well. A person who rates his or her pain out of 10 as being a nine, may report it to be four if they weren’t dealing with other stresses, such as financial distress, divorce, or issues in the workplace.
Twenty per cent of Canadians live with moderate to severe chronic pain. Is it possible we are not recognizing how unique pain is to the individual? This is why I believe pain management can be so difficult. Successful pain management should go beyond a “one size fits all” prescription and should recognize how much pain affects our life and how much life affects our pain.
The views and opinions expressed in this article are those of the author, and do not necessarily reflect the position of this publication.
