“Rate your pain on a scale of one to ten”. If you’ve never been asked that question you’re lucky, but most of the rest of us have heard it at least once. Vital signs such as blood pressure, respiratory rate, temperature, or kidney function are quantifiable, but pain, no matter where it seems to originate, is ‘all in your head’. It’s totally subjective, and a host of factors can influence both the experience and reporting of pain levels. For example, while the 1-10 scale is trusted and about as accurate as other scales, it has inherent problems…
“The 2014 edition of the textbook “Nursing: A Concept-Based Approach to Learning” warned practitioners that Native Americans “may pick a sacred number when asked to rate pain,” and that the validity of self-reports will likely be affected by the fact that Jewish people “believe that pain must be shared” and black people “believe suffering and pain are inevitable.” Last year, the book’s publisher, Pearson, announced that it would remove the offending passage from future editions, but biases remain common, and study after study has shown shocking disparities in pain treatment.”
Scientists have been working with Functional Magnetic Resonance Imaging (FMRI) to watch the brain’s response to pain in real-time, while the pain is being inflicted, and the results are fascinating. Click here for an excellent article from The New Yorker on the history of pain studies, how FMRI is opening new doors on our understanding of pain, what one woman’s experience as a pain guinea pig was like, and what the implications of objectively measurable pain could be for medicine, law, and the rest of our world.
