11 ms·

Researchers search for more precise ways to measure pain

92 points by Petiver 2y ago

dkenyser 2y ago
https://archive.is/kgtlw https://archive.is/kgtlw
perching_aix 2y ago
I've been recently wondering if this is a "thing" in medical research, and I'm extremely glad to hear that it is. Especially in tech I think we all know how frustrating it is to only ever get vague, pre-interpreted reports of issues, particularly when those issues are non-deterministic or otherwise tough-to-reproduce. I can only hope that once these methods mature to everyday use levels, people will keep in mind the gap between the measurement and the phenomenon. Just like how a GPS tracker doesn't track the object (or pet, or whatever) you put it on but itself, these methods will also only detect pain they're compatible with detecting, and miss others. I can already imagine the conversations with various parties insisting that a patient isn't actually feeling pain because whatever devices are not reporting so (or the opposite!). Still, I don't think this should keep these devices from existing.
- PaulKeeble 2y ago
  They might miss a type of pain that the current trials aren't measuring because healthcare doesn't believe that group of patients and further entrench that prejudice into the measure. It's a very real risk of such a device.
PaulKeeble 2y ago
In the meantime if you are actually in chronic pain it's worth knowing research has shown that 6 out of 10 is the best number for patients to use. Below 6 and insurance doesn't pay out and healthcare workers consider it normal and if your not writhing and scream on agony right now you can't possibly be above. 6 has the best chance of success. Alas even the best is not a high chance there are millions suffering chronic pain, because in the absence of a biomarker and withdrawal of opioids, many probably most sufferers are left without any relief and suffer the consequences. It's not about you it's about the doctor there was nothing you could have done, prejudice and stigma over pain is rife within healthcare.
j_bum 2y ago
I have a PhD in neuroscience, where I studied circadian rhythm disruption and its effect on pain behavior. So I feel qualified to discuss this. In humans, pain has two primary components [0]: 1. The sensory-discriminative component: where on my body, what type (hot? cold? chemical?), and how intense is the noxious stimulus? 2. The affective-emotional component: how much does the pain hurt, and how does it affect emotional state? Very importantly, both #1 and #2 are considered “pain”, and they can be experienced both simultaneously and independently. Pain is entirely subjective, as TFA highlights. It does sound valuable to search for biomarkers of the sensory-discriminative component. But I’m doubtful that biomarkers for #2 are readily observable, beyond fMRI. The “Nociometer” may capture this, but what if it doesn’t in a reliable way, since it’s designed to test #1? TFA discussed how this could save money for health-care system money; this gives me an awful feeling. Relying on “biomarker-based pain measurements” worries me that patients who are primarily experiencing affective-emotional components of pain will only further be doubted or not trusted by physicians. There are already far, far too many examples of physicians not trust patients about pain. Re: women at Yale undergoing IVF treatments without fentanyl injections due to a drug misusing nurse stealing the fentanyl. Physicians responded to the unanesthetized women in excruciating pain by saying, “maybe you are immune to fentanyl!” [1*]. I think we should tread lightly. — [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC6676053/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6676053/ [1] https://www.nytimes.com/2024/09/09/health/yale-ivf-egg-retrievals-lawsuit.html https://www.nytimes.com/2024/09/09/health/yale-ivf-egg-retri... *There is a heart breaking podcast on this scandal, which is how I originally learned about it [2]. Of course when I was in horror telling my wife about the story, the news came as no surprise to her, as she’s experienced pain disbelief from physicians her entire life. [2] https://www.thisamericanlife.org/804/the-retrievals https://www.thisamericanlife.org/804/the-retrievals
- odyssey7 2y ago
  Maybe this explanation is intentionally simplified, but what it’s telling me is that medical science is just lost.
  - j_bum 2y ago
    Well, I wouldn’t go that far. The brain is incredibly complicated, and frankly we are still very far from understanding much about how it works. But this doesn’t mean we aren’t making incredible advancements. Discoveries are constantly being made in the background and are continuing to build up over time. For example, a non-addictive pain medication was just approved by the FDA [0]. This will undoubtedly improve millions of lives and prevent uncountable numbers of people from misusing opiates in the future. [0] https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain https://www.fda.gov/news-events/press-announcements/fda-appr...
INTPenis 2y ago
True scifi will be when the doctor can use a machine to feel what the patient feels. "Ah, now I see Mr. K. Dilkington. You clearly have old cold belly badness."
- kevlened 2y ago
  This is a Black Mirror episode based on a short story by Penn Jillette (of Penn & Teller) https://en.wikipedia.org/wiki/Black_Museum_(Black_Mirror) https://en.wikipedia.org/wiki/Black_Museum_(Black_Mirror)
- petercooper 2y ago
  Poor misunderstood Karl. I knew what he meant when he said that glass ashtrays hold cold.
Fin_Code 2y ago
Pain is relative to experience and tolerance. Using patient input is inherently flawed.
- taneq 2y ago
  I'm unsure how to interpret this statement. Are you saying that the amount of pain experienced depends on the patient's prior exposure and some 'tolerance' stat? And that we should ignore their actual statements about, and reactions to, stimulus when assessing the effect of that stimulus on them?
  - debacle 2y ago
    My son had a testicular torsion. Normally, this is 10/10 pain and vomiting and fever and shock. All sorts of awfulness. If you didn't know it, you would have assumed his pain was no more than 4/10. It took an insistent pediatric nurse to convince us that something very serious was going on and that he needed to go to the ER right away.
  - kulahan 2y ago
    I would agree with him if I think about it. Pain is a side effect. You are never trying to treat pain, you’re trying to treat whatever is causing pain. This doesn’t even get into the fact that people might experience diminished or increased pain for a myriad of reasons which could completely throw off the severity assessment. There are probably better methods to determine the seriousness of a scenario? I’m not a doctor.
    - taneq 2y ago
      I see where you're coming from but I think you're completely missing the actual discussion. Sure, The degree of perceived pain might be affected by many other factors. There's no distinction between 'pain' and 'perception of pain' because pain is a perception. Sure, we're not trying to fix the pain, we're trying to fix the problem, and the pain is a symptom of the problem. However, this is an actual person we're trying to fix, and their pain is real, to them. I'm not sure in what way some quibble about "oh it's not actually caused by mechanical damage to your left clavicle, it's just a sensor issue" is going to comfort someone whose shoulder is fuckin' killing them. We need to fix that shoulder bearing, sure, but we also need to mute the alarms for a while, because we're not monsters.
gaoshan 2y ago
Probably not exactly the same but I remember trying to describe a type of pain I felt to a doctor in the US. I called it "sour" (which is how it would be described in Chinese) and the doctor laughed saying that didn't mean anything to him. I think it is extremely accurate and descriptive but to him it didn't even register as having meaning.
- elric 2y ago
  I am often baffled by how some people are able to articulate how a specific pain feels or even where exactly the pain is. Describing pain intensity is hard beyond "not very painful" and "very painful". But adding a dimension of pain type is something I struggle with. Sour pain makes as much sense to me as piercing pain, which is to say: no sense at all. I've been pierced (not for fun or aesthetics) by large nails in an accident, and it felt nothing like the icepick headaches I get, which my doctor tells me are a piercing pain. Human internal experience is weird as fuck. If it can help diagnostics in any way, I'm all for more precise pain measurements. But I'm sure someone will abuse that research for torture.
  - BurningFrog 2y ago
    I think it's entirely possible that different people experience pain very differently. If true, that makes it fundamentally impossible to fully communicate about it. I read an SF story where telepaths were as doctors. They'd enter the patient's mind, feel what they feel, and recognize the symtoms, because they had actually felt how all common conditions feel. Maybe we can get to something similar with AI and brain scanning one day?
    - kulahan 2y ago
      It would be wild if everyone experienced pain differently despite having pretty much identical tools for experiencing it. That would probably open so many cans of worms…
    - ALittleLight 2y ago
      Even without telepathy I think AI will get there. Doctors don't have that much time or access with a patient. Imagine telling ChatGPT what you feel, what your symptoms are, it asks follow up questions, gives some suggestions on changes or over the counter remedies, and comes to a diagnosis. Once ChatGPT has done that 10 million times, and can learn from or search those records, vague descriptions of symptoms will likely sound pretty similar.
dedifhfj 2y ago
[flagged]
lijok 2y ago
Any kind of accurate pain measurement mechanism would be revolutionary in veterinary care. We recently found ourselves in a horrible situation. Our dog rapidly came down with a mystery illness that saw him go from bouncy to unable to stand in the span of a few hours. 6 hours of testing, 2nd opinions and specialists on the other side of the planet, and noone had a clue what was going on. A ridiculously primitive pain assessment was run, and we were advised that the dog was suffering and we should let him go. Millions of animals are put down every year on the premise they are in pain, usually without strong data, with owners left to wonder if it was too early.
m3kw9 2y ago
Pain is relative because the psychological factor can amplify pain, say, someone afraid of getting a needle. The amount of hate they have for it definitely makes it worse
- derbOac 2y ago
  I think it's great to bring more measures of pain to bear on things but admit I'm disturbed by the rhetoric around things. It's a classic problem with measuring anything neuropsychological: pain is inherently subjective. So when I read an entire article talking about how we need "objective" rather than "subjective" measures of pain it seems not only logically and scientifically misguided, but also inherently dismissive of patient experience, like their subjective experience is irrelevant. The thing you're measuring is a subjective experiential quantity. There's so much literature showing that inherently "psychological" things are integral to pain experience there's no way to disentangle them. Another poster was noting that pain is affected by experience — so if a pain is new to a patient, does that mean we should ignore their experience of it? If we know that pain perception is amplified by anxiety or fear, we should dismiss it? I know from firsthand clinical experience the problems with report of pain — misrepresentation in drug seeking, for example — but I almost feel like you'd be better off studying that than anything else. The rest of the stuff they mention is great and all parts of the puzzle but it's all minor parts of the whole process of pain perception, and the whole idea of dismissing "subjective" pain seems absurd to me, because pain is subjective.
GarnetFloride 2y ago
I've been interested in pain and pain management since having a drunk driver crash into us. I've even moderated a panel of doctors who specialized in pain. How people deal with acute vs chronic pain can be very different. One doctor blew my mind when he described chronic pain as a spousal relationship. It's something you have to live with and work with. You can't ignore or bully pain. Also men and women deal with pain differently. Most men describe a heart attack as the worst pain ever. Many women have ignored heart attacks because it wasn't as bad as their period pains. Women also describe kidney stones as worse than childbirth. I had a friend go in to the doctor and described the pain as a 5. But the doctor noticed they were sweating because of pain, which made it at least a 7 in their experience as that was an involuntary physical response. I've been to places not described on the pain scale, when I was recovering from surgery the IV drop ran out, the pain was so bad my spirit phased out of my body slightly so I was less aware of the pain but could still see the nurse running around trying to load another bag into the IV dispenser. I can tell when a bad storm is coming because it feels like water running down the inside of my leg bone, like runoff down a gutter. Some days the pain is dull and I can get irritated easily, but some over the counter pain medications are helpful. So if I am going to the doctor I've already exhausted the available options, so pain is high priority to me as I can't do things. I have also noticed that men's pain is taken more seriously than women's pain. Redheads get less pain relief and if you are person of color, especially a female, doctors take your pain least seriously. It makes me wonder how they actually teach in med school for that to happen. Describing the pain in terms of what work I can and cannot do gets more attention than anything else.
- newfocogi 2y ago
  "Redheads get less pain relief" - are there any references you have so I can explore this more?
  - dullcrisp 2y ago
    https://www.nih.gov/news-events/nih-research-matters/study-finds-link-between-red-hair-pain-threshold https://www.nih.gov/news-events/nih-research-matters/study-f...
  - 2y ago
_DeadFred_ 2y ago
I added a children's pain scale to some software (faces in varying levels of pain that children can point to). I know my mom had chronic back pain that she complained about, but I never really thought about it. She functioned, she got through life. She was over for dinner at the time and I must have brought the scale up in discussion. I grabbed a paper copy and asked her what her pain level was, and she pointed to the second worst. Even after that I just kind of wrote off her pain like, she functions (though sometimes I would have to go get her as she got stranded in a supermarket in too much pain to move), and that's just life. I can watch a movie of some random acting dog whimper and fake limp and have to wipe tears from my eyes, but almost instantly went to ignoring my own mother's pain because she powered through. I hope it's not because acknowledging my mother's pain would have created a cost for me (doing more for her, acknowledging would create a long term burden on me versus the quick/easy/kind of cathartic/self serving release of emotion of a sad movie) but part of me thinks that's partially the case. What's the point in measuring when our response is still just a shrug?
metalman 2y ago
a graduated set of instuments starting with a short, thin, very pointy pin then the same, dipped in weak.acid then bigger pins, and stronger acids the get them hot etc,etc sort of a micro tortures starter kit, but all calibrated and then a big pile of money, to attract volunteirs there is already a group that has been doing this with insect stings and bites, with the worst bieng some kind of mega sized japanese hornet, which the description of was, as an awe inspiring combination of bieng stabed with something dipped in hot acid, so.....
shadowtree 2y ago
Hard challenge, as pain is a subjective definition and you can't intellectually comprehend it until you're in it. I got the scale 10 questions before I had a badly herniated disc and never knew what to say. Now I can tell you that a 10 is when you're begging for mercy. Hearing yourself whimpering. Having panic from making another move, another step. To be clear, it is not just the amount of pain itself - it's also a function of duration and consistency. Once pain always fires, in any position, and no remedy (besides a Fentanyl infusion) provides even temporary pause, you get in a spiral that kills quite a lot of people. Sometimes called Chronic Pain, it is easily dismissed but so damn hard to comprehend until you experience it. Like Tinnitus, just with the rawest brain signal that triggers fight or flight. Coming back to measuring pain - that time axis is critical.
failrate 2y ago
I have never had a doctor ask me what flavor my pain is, but I can easily describe various types of pain as e.g. spicy, sour, bitter, etc.
pugworthy 2y ago
Another one with an, “I dunno, 5 maybe?” story. I had a heart attack 2 months ago and got asked the 1-10 thing 4-5 times in the middle of it. I had classic left side chest and back of my arm pain. Kinda made up a number but told them I definitely felt shitty. I did ask my cardiologist how she’d rate my heart attack on a scale of 1-10 for severity. She laughed and said nobody had asked her that before. Then said 7.

92 points by Petiver 2y ago

https://archive.is/kgtlw https://archive.is/kgtlw

I've been recently wondering if this is a "thing" in medical research, and I'm extremely glad to hear that it is. Especially in tech I think we all know how frustrating it is to only ever get vague, pre-interpreted reports of issues, particularly when those issues are non-deterministic or otherwise tough-to-reproduce. I can only hope that once these methods mature to everyday use levels, people will keep in mind the gap between the measurement and the phenomenon. Just like how a GPS tracker doesn't track the object (or pet, or whatever) you put it on but itself, these methods will also only detect pain they're compatible with detecting, and miss others. I can already imagine the conversations with various parties insisting that a patient isn't actually feeling pain because whatever devices are not reporting so (or the opposite!). Still, I don't think this should keep these devices from existing.

PaulKeeble 2y ago
They might miss a type of pain that the current trials aren't measuring because healthcare doesn't believe that group of patients and further entrench that prejudice into the measure. It's a very real risk of such a device.

PaulKeeble 2y ago

In the meantime if you are actually in chronic pain it's worth knowing research has shown that 6 out of 10 is the best number for patients to use. Below 6 and insurance doesn't pay out and healthcare workers consider it normal and if your not writhing and scream on agony right now you can't possibly be above. 6 has the best chance of success. Alas even the best is not a high chance there are millions suffering chronic pain, because in the absence of a biomarker and withdrawal of opioids, many probably most sufferers are left without any relief and suffer the consequences. It's not about you it's about the doctor there was nothing you could have done, prejudice and stigma over pain is rife within healthcare.

j_bum 2y ago

I have a PhD in neuroscience, where I studied circadian rhythm disruption and its effect on pain behavior. So I feel qualified to discuss this. In humans, pain has two primary components [0]: 1. The sensory-discriminative component: where on my body, what type (hot? cold? chemical?), and how intense is the noxious stimulus? 2. The affective-emotional component: how much does the pain hurt, and how does it affect emotional state? Very importantly, both #1 and #2 are considered “pain”, and they can be experienced both simultaneously and independently. Pain is entirely subjective, as TFA highlights. It does sound valuable to search for biomarkers of the sensory-discriminative component. But I’m doubtful that biomarkers for #2 are readily observable, beyond fMRI. The “Nociometer” may capture this, but what if it doesn’t in a reliable way, since it’s designed to test #1? TFA discussed how this could save money for health-care system money; this gives me an awful feeling. Relying on “biomarker-based pain measurements” worries me that patients who are primarily experiencing affective-emotional components of pain will only further be doubted or not trusted by physicians. There are already far, far too many examples of physicians not trust patients about pain. Re: women at Yale undergoing IVF treatments without fentanyl injections due to a drug misusing nurse stealing the fentanyl. Physicians responded to the unanesthetized women in excruciating pain by saying, “maybe you are immune to fentanyl!” [1*]. I think we should tread lightly. — [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC6676053/ https://pmc.ncbi.nlm.nih.gov/articles/PMC6676053/ [1] https://www.nytimes.com/2024/09/09/health/yale-ivf-egg-retrievals-lawsuit.html https://www.nytimes.com/2024/09/09/health/yale-ivf-egg-retri... *There is a heart breaking podcast on this scandal, which is how I originally learned about it [2]. Of course when I was in horror telling my wife about the story, the news came as no surprise to her, as she’s experienced pain disbelief from physicians her entire life. [2] https://www.thisamericanlife.org/804/the-retrievals https://www.thisamericanlife.org/804/the-retrievals

odyssey7 2y ago
Maybe this explanation is intentionally simplified, but what it’s telling me is that medical science is just lost.
- j_bum 2y ago
  Well, I wouldn’t go that far. The brain is incredibly complicated, and frankly we are still very far from understanding much about how it works. But this doesn’t mean we aren’t making incredible advancements. Discoveries are constantly being made in the background and are continuing to build up over time. For example, a non-addictive pain medication was just approved by the FDA [0]. This will undoubtedly improve millions of lives and prevent uncountable numbers of people from misusing opiates in the future. [0] https://www.fda.gov/news-events/press-announcements/fda-approves-novel-non-opioid-treatment-moderate-severe-acute-pain https://www.fda.gov/news-events/press-announcements/fda-appr...

INTPenis 2y ago

True scifi will be when the doctor can use a machine to feel what the patient feels. "Ah, now I see Mr. K. Dilkington. You clearly have old cold belly badness."

kevlened 2y ago
This is a Black Mirror episode based on a short story by Penn Jillette (of Penn & Teller) https://en.wikipedia.org/wiki/Black_Museum_(Black_Mirror) https://en.wikipedia.org/wiki/Black_Museum_(Black_Mirror)
petercooper 2y ago
Poor misunderstood Karl. I knew what he meant when he said that glass ashtrays hold cold.

Fin_Code 2y ago

Pain is relative to experience and tolerance. Using patient input is inherently flawed.

taneq 2y ago
I'm unsure how to interpret this statement. Are you saying that the amount of pain experienced depends on the patient's prior exposure and some 'tolerance' stat? And that we should ignore their actual statements about, and reactions to, stimulus when assessing the effect of that stimulus on them?
- debacle 2y ago
  My son had a testicular torsion. Normally, this is 10/10 pain and vomiting and fever and shock. All sorts of awfulness. If you didn't know it, you would have assumed his pain was no more than 4/10. It took an insistent pediatric nurse to convince us that something very serious was going on and that he needed to go to the ER right away.
- kulahan 2y ago
  I would agree with him if I think about it. Pain is a side effect. You are never trying to treat pain, you’re trying to treat whatever is causing pain. This doesn’t even get into the fact that people might experience diminished or increased pain for a myriad of reasons which could completely throw off the severity assessment. There are probably better methods to determine the seriousness of a scenario? I’m not a doctor.
  - taneq 2y ago
    I see where you're coming from but I think you're completely missing the actual discussion. Sure, The degree of perceived pain might be affected by many other factors. There's no distinction between 'pain' and 'perception of pain' because pain is a perception. Sure, we're not trying to fix the pain, we're trying to fix the problem, and the pain is a symptom of the problem. However, this is an actual person we're trying to fix, and their pain is real, to them. I'm not sure in what way some quibble about "oh it's not actually caused by mechanical damage to your left clavicle, it's just a sensor issue" is going to comfort someone whose shoulder is fuckin' killing them. We need to fix that shoulder bearing, sure, but we also need to mute the alarms for a while, because we're not monsters.

gaoshan 2y ago

Probably not exactly the same but I remember trying to describe a type of pain I felt to a doctor in the US. I called it "sour" (which is how it would be described in Chinese) and the doctor laughed saying that didn't mean anything to him. I think it is extremely accurate and descriptive but to him it didn't even register as having meaning.

elric 2y ago
I am often baffled by how some people are able to articulate how a specific pain feels or even where exactly the pain is. Describing pain intensity is hard beyond "not very painful" and "very painful". But adding a dimension of pain type is something I struggle with. Sour pain makes as much sense to me as piercing pain, which is to say: no sense at all. I've been pierced (not for fun or aesthetics) by large nails in an accident, and it felt nothing like the icepick headaches I get, which my doctor tells me are a piercing pain. Human internal experience is weird as fuck. If it can help diagnostics in any way, I'm all for more precise pain measurements. But I'm sure someone will abuse that research for torture.
- BurningFrog 2y ago
  I think it's entirely possible that different people experience pain very differently. If true, that makes it fundamentally impossible to fully communicate about it. I read an SF story where telepaths were as doctors. They'd enter the patient's mind, feel what they feel, and recognize the symtoms, because they had actually felt how all common conditions feel. Maybe we can get to something similar with AI and brain scanning one day?
  - kulahan 2y ago
    It would be wild if everyone experienced pain differently despite having pretty much identical tools for experiencing it. That would probably open so many cans of worms…
  - ALittleLight 2y ago
    Even without telepathy I think AI will get there. Doctors don't have that much time or access with a patient. Imagine telling ChatGPT what you feel, what your symptoms are, it asks follow up questions, gives some suggestions on changes or over the counter remedies, and comes to a diagnosis. Once ChatGPT has done that 10 million times, and can learn from or search those records, vague descriptions of symptoms will likely sound pretty similar.

dedifhfj 2y ago

[flagged]

lijok 2y ago

Any kind of accurate pain measurement mechanism would be revolutionary in veterinary care. We recently found ourselves in a horrible situation. Our dog rapidly came down with a mystery illness that saw him go from bouncy to unable to stand in the span of a few hours. 6 hours of testing, 2nd opinions and specialists on the other side of the planet, and noone had a clue what was going on. A ridiculously primitive pain assessment was run, and we were advised that the dog was suffering and we should let him go. Millions of animals are put down every year on the premise they are in pain, usually without strong data, with owners left to wonder if it was too early.

m3kw9 2y ago

Pain is relative because the psychological factor can amplify pain, say, someone afraid of getting a needle. The amount of hate they have for it definitely makes it worse

derbOac 2y ago
I think it's great to bring more measures of pain to bear on things but admit I'm disturbed by the rhetoric around things. It's a classic problem with measuring anything neuropsychological: pain is inherently subjective. So when I read an entire article talking about how we need "objective" rather than "subjective" measures of pain it seems not only logically and scientifically misguided, but also inherently dismissive of patient experience, like their subjective experience is irrelevant. The thing you're measuring is a subjective experiential quantity. There's so much literature showing that inherently "psychological" things are integral to pain experience there's no way to disentangle them. Another poster was noting that pain is affected by experience — so if a pain is new to a patient, does that mean we should ignore their experience of it? If we know that pain perception is amplified by anxiety or fear, we should dismiss it? I know from firsthand clinical experience the problems with report of pain — misrepresentation in drug seeking, for example — but I almost feel like you'd be better off studying that than anything else. The rest of the stuff they mention is great and all parts of the puzzle but it's all minor parts of the whole process of pain perception, and the whole idea of dismissing "subjective" pain seems absurd to me, because pain is subjective.

GarnetFloride 2y ago

I've been interested in pain and pain management since having a drunk driver crash into us. I've even moderated a panel of doctors who specialized in pain. How people deal with acute vs chronic pain can be very different. One doctor blew my mind when he described chronic pain as a spousal relationship. It's something you have to live with and work with. You can't ignore or bully pain. Also men and women deal with pain differently. Most men describe a heart attack as the worst pain ever. Many women have ignored heart attacks because it wasn't as bad as their period pains. Women also describe kidney stones as worse than childbirth. I had a friend go in to the doctor and described the pain as a 5. But the doctor noticed they were sweating because of pain, which made it at least a 7 in their experience as that was an involuntary physical response. I've been to places not described on the pain scale, when I was recovering from surgery the IV drop ran out, the pain was so bad my spirit phased out of my body slightly so I was less aware of the pain but could still see the nurse running around trying to load another bag into the IV dispenser. I can tell when a bad storm is coming because it feels like water running down the inside of my leg bone, like runoff down a gutter. Some days the pain is dull and I can get irritated easily, but some over the counter pain medications are helpful. So if I am going to the doctor I've already exhausted the available options, so pain is high priority to me as I can't do things. I have also noticed that men's pain is taken more seriously than women's pain. Redheads get less pain relief and if you are person of color, especially a female, doctors take your pain least seriously. It makes me wonder how they actually teach in med school for that to happen. Describing the pain in terms of what work I can and cannot do gets more attention than anything else.

newfocogi 2y ago
"Redheads get less pain relief" - are there any references you have so I can explore this more?
- dullcrisp 2y ago
  https://www.nih.gov/news-events/nih-research-matters/study-finds-link-between-red-hair-pain-threshold https://www.nih.gov/news-events/nih-research-matters/study-f...
- 2y ago

_DeadFred_ 2y ago

I added a children's pain scale to some software (faces in varying levels of pain that children can point to). I know my mom had chronic back pain that she complained about, but I never really thought about it. She functioned, she got through life. She was over for dinner at the time and I must have brought the scale up in discussion. I grabbed a paper copy and asked her what her pain level was, and she pointed to the second worst. Even after that I just kind of wrote off her pain like, she functions (though sometimes I would have to go get her as she got stranded in a supermarket in too much pain to move), and that's just life. I can watch a movie of some random acting dog whimper and fake limp and have to wipe tears from my eyes, but almost instantly went to ignoring my own mother's pain because she powered through. I hope it's not because acknowledging my mother's pain would have created a cost for me (doing more for her, acknowledging would create a long term burden on me versus the quick/easy/kind of cathartic/self serving release of emotion of a sad movie) but part of me thinks that's partially the case. What's the point in measuring when our response is still just a shrug?

metalman 2y ago

a graduated set of instuments starting with a short, thin, very pointy pin then the same, dipped in weak.acid then bigger pins, and stronger acids the get them hot etc,etc sort of a micro tortures starter kit, but all calibrated and then a big pile of money, to attract volunteirs there is already a group that has been doing this with insect stings and bites, with the worst bieng some kind of mega sized japanese hornet, which the description of was, as an awe inspiring combination of bieng stabed with something dipped in hot acid, so.....

shadowtree 2y ago

Hard challenge, as pain is a subjective definition and you can't intellectually comprehend it until you're in it. I got the scale 10 questions before I had a badly herniated disc and never knew what to say. Now I can tell you that a 10 is when you're begging for mercy. Hearing yourself whimpering. Having panic from making another move, another step. To be clear, it is not just the amount of pain itself - it's also a function of duration and consistency. Once pain always fires, in any position, and no remedy (besides a Fentanyl infusion) provides even temporary pause, you get in a spiral that kills quite a lot of people. Sometimes called Chronic Pain, it is easily dismissed but so damn hard to comprehend until you experience it. Like Tinnitus, just with the rawest brain signal that triggers fight or flight. Coming back to measuring pain - that time axis is critical.

failrate 2y ago

I have never had a doctor ask me what flavor my pain is, but I can easily describe various types of pain as e.g. spicy, sour, bitter, etc.

pugworthy 2y ago

Another one with an, “I dunno, 5 maybe?” story. I had a heart attack 2 months ago and got asked the 1-10 thing 4-5 times in the middle of it. I had classic left side chest and back of my arm pain. Kinda made up a number but told them I definitely felt shitty. I did ask my cardiologist how she’d rate my heart attack on a scale of 1-10 for severity. She laughed and said nobody had asked her that before. Then said 7.