- 10 is the worst pain you've ever felt
- 10 is surgery without anesthesia
- 10 is the worst pain you can imagine
Much like the guy in xkcd, I can imagine a whole lot worse pain than I've ever felt.
Allie Brosh (of Hyperbole and a Half) also had a great comic about pain scales. She proposed a better one. It goes to 11.
I feel like there should be more than 10 numbers between "I feel totally awesome" and "I have been stung by a platypus." Or at least they should give some more guidance in between. Less than 4 seems like it shouldn't deserve notice, but anything over about 6 feels like I'm being dramatic. Because after all, if I'm conscious and able to respond to your question, I can't be in all that much pain in the grand scheme of things, right?
And do most medical professionals mentally re-scale on the assumption that patients are always dramatic? Do they expect that most people thinking "DAMN THIS HURTS" will immediately claim to be 10/10, and therefore anything much less than that means "I pricked my finger"? I should ask my MD/Ph.D buddy.
1 comments:
Honestly, it doesn't matter what the absolute number or pain representation is. What matters is: 1) If you want the pain to be remedied. Even if the patient is overly dramatic and their 10/10 pain is your paper cut (which of course is impossible to tell), if they want pain relief in a non-substance abusive way, then it's worth noting. Also, two people can report 4/10 pain, one can say they want some tylenol, the other is fine without it, so we just treat one and not the other-but we're not going to treat either of them with morphine. 2) Follow-up- whether their number has decreased because they've become less dramatic or if the medication works doesn't matter if they tolerate a decreased dosage and 3)Even with variability of pain thresholds across the population the pain scale is useful for differential diagnosis. The point of the scale is a quick assessment that can be followed through time by several different doctors. It's not supposed to give us a sudden insight into exactly what you're feeling. Any more nuance to the scale itself would not be helpful; instead, added descriptions by the patient (location, radiation, sharp vs dull, etc) is much more important. Does that make sense? I think when you are NOT in a pain situation it's hard to imagine a 10/10 in an honest visceral way (I mean, what would ebola REALLY feel like?!) but overall in a hospital with the gamut of diseases and injuries the scale works pretty well.
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