The rate your pain from one through to ten scale is hopeless in chronic pain ,and I cant believe many doctors still use it . At the neurologists yesterday I was asked to rate my pain ,with 10 being the worst pain imaginable. I found myself sitting there unable to formulate a reply . I couldn’t say 10 of course , I have had gallstone attacks and two births and I know that at that level of pain you are on the floor unable to speak ,hear or respond in any way .At that point breathing seems impossible. So clearly I couldn’t say 10 ,I was sitting in his office after all,not on the floor screaming .Why did I so desperately want to shout - ten , its ten!!!
OF course , simply put I just wanted help and by using a rating system it suggests that the higher you rate the pain the more help you might get. If I used a lower rating the doctor might judge my pain to be insignificant or acceptable. At that moment it struck me that he would judge what I have to endure. Surely only I could be the judge of that,surely it is well known that chronic pain wears away at your strength and resolve ,fraying nerves until emotions are raw. Dear doctor ,how does your rating scale take chronic pains unremitting presence into account ?
So I decided to tell it like it is .I told the truth ,"as I sit here its a 3 ,it will be a 4 as I walk out of here " Not too bad BUT here is the kicker - I quickly added that I wanted him to imagine standing on a tack .Hurts a bit- however imagine you are not allowed to take that tack out of your foot EVER. You have to walk with it in there and yep,it will hurt more the further you go and if you are lucky ,it might feel better when you rest .Oh,and by the way ,put a tack in the ball of your other foot - thats there forever too.I really wanted to add he could stick a tack in the back of each hand because they hurt too ,but I wanted to quit while I was ahead.
Thats what chronic pain is for me ,its all about the unrelenting nature of it .It is not something that can fit neatly on a one to ten scale .I think that only I can be the judge of it and I would rather be asked how I am coping ! That scale at best trivialises chronic pain and at worst makes suffers look vaguely hysterical or opiate seeking( use the tantalisingly high score and watch your credibility go down) Well, don’t know if anything has changed , but I doubt one neurologist will be using that rating scale too blithely - even if it is potential rants he’s avoiding !!!
Well said Tizzy. I was continually frustrated by this question when I had my recent accident. On my reply depended the amount of painkiller they were about to give me and I was in agony and wanted the max! The pain of childbirth comes and goes and at last is over. The pain I was in could last at least 28 hours until they could operate and probably a lot longer afterwards. It was far greater than the pain of EM but it too was for a finite time. What I am trying to say is that a lesser pain which cannot be helped by drugs and can last for months, years, should be higher up the scale than a short sharp terrible pain which you know will be reduced by painkillers and time. So the use of the scale is nonsense really.
Nel