Measure Pain: Is There an Equation?

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    Measurement Pain
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Discussion Overview

The discussion revolves around the challenge of measuring pain, exploring whether it can be quantified through an equation or scale. Participants consider various methods of assessment, including subjective scales and indirect measures, while addressing the inherent subjectivity of pain experiences.

Discussion Character

  • Exploratory
  • Debate/contested
  • Conceptual clarification

Main Points Raised

  • Some participants propose an analogy between pain and electrical measurements, suggesting that voltage could represent pain intensity, resistance could represent a person's tolerance, and current could represent the pain felt.
  • Others mention that while there is no direct electrical measurement for pain, research into facial expressions has been explored as a potential method for assessing pain levels.
  • One participant notes that medical professionals often rely on subjective assessments of pain, which they find to be meaningless in an objective sense, suggesting that facial expression assessments may provide a more realistic measure.
  • In emergency medical services (EMS), a 1-10 pain scale is commonly used, although its effectiveness is questioned due to variability in individual pain tolerance. Participants discuss its utility for tracking changes in a patient's condition over time.
  • Another participant shares anecdotal experiences regarding the subjective nature of pain, referencing personal stories and humor related to pain perception.
  • Some participants highlight the complexity of pain as a subjective experience, suggesting that creating a precise and consistent objective pain scale may be impossible. They emphasize the variability in pain responses among individuals and across different contexts.

Areas of Agreement / Disagreement

Participants generally agree on the subjective nature of pain and the limitations of current measurement methods. However, there are multiple competing views regarding the effectiveness of different pain assessment techniques, and the discussion remains unresolved on the best approach to quantify pain.

Contextual Notes

Limitations include the dependence on individual definitions of pain, the variability in responses to similar stimuli, and the challenges in establishing a universally applicable pain scale.

Psyguy22
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I was just wondering if there's a way to measure pain. I figured it'd be and equation like current. Like voltage would be the amount of pain, ohm would be a persons resistance to pain, and current would be the pain they actually felt.
 
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Psyguy22 said:
I was just wondering if there's a way to measure pain. I figured it'd be and equation like current. Like voltage would be the amount of pain, ohm would be a persons resistance to pain, and current would be the pain they actually felt.

I'm not aware of any direct electrical measurements that can assess pain, but there has been some research into using facial expressions to assist in assessing pain:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706565/

http://www.google.com/url?sa=t&rct=...70WRKA01PXIuUW6EvUAeC7A&bvm=bv.65058239,d.aWc

Summary of various pain scales: http://pain.about.com/od/testingdiagnosis/a/pain_scales.htm

.
 
I've had various occasions to have nurses or doctors ask me how much pain I'm in and there has never been any attempt to quantify it. It was always purely subjective and I've talked to a couple of them and they agree that the answers they get to that question are utterly meaningless in any objective sense. I do think that the facial expression test mentioned about would be at least closer to realistic than just asking.
 
In EMS, we use the 1-10 scale for pain (where a 10 is the worst pain you've ever felt in your life). Yeah, for middle numbers it doesn't hold a lot of meaning, since folks' pain tolerance varies quite a bit. But for trending a patient over the time that you are working with them, it can be very helpful.

For example, if I'm called to assess a patient who is complaining of chest pain, I'll ask how long ago it started, and on the 1-10 scale, how much did it hurt then, and how much does it hurt now. I can ask the same question later in the assessment, to see if things are getting worse or holding steady for a while...

And usually, when a reliable patient says the pain is an 8 or a 9, that's a pretty big flag that things may be serious...
 
berkeman said:
In EMS, we use the 1-10 scale for pain (where a 10 is the worst pain you've ever felt in your life). Yeah, for middle numbers it doesn't hold a lot of meaning, since folks' pain tolerance varies quite a bit. But for trending a patient over the time that you are working with them, it can be very helpful.

For example, if I'm called to assess a patient who is complaining of chest pain, I'll ask how long ago it started, and on the 1-10 scale, how much did it hurt then, and how much does it hurt now. I can ask the same question later in the assessment, to see if things are getting worse or holding steady for a while...

And usually, when a reliable patient says the pain is an 8 or a 9, that's a pretty big flag that things may be serious...

pain_rating.png


http://hyperboleandahalf.blogspot.be/2010/02/boyfriend-doesnt-have-ebola-probably.html
 
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:smile:
 
The lead instructor for a Wilderness First Aid course (that I help out at) says that her "10" was a couple days of dealing with kidney stones. She has some stories that will curl your toes! :eek:
 
Brian Regan has a great bit about this:


There has also been some interesting work done on perception of pain that suggests that most people do not remember it in terms of intensity integrated over duration. Sorry I don't have any links on that. I remember reading about it in Khaneman's "Thinking Fast and Slow."
 
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Choppy said:
Brian Regan has a great bit about this:


There has also been some interesting work done on perception of pain that suggests that most people do not remember it in terms of intensity integrated over duration. Sorry I don't have any links on that. I remember reading about it in Khaneman's "Thinking Fast and Slow."


Yeah, they say that if women really remembered how painful childbirth is, they would never do it more than once. I'm just GUESSING at how painful it is, and I wouldn't want to do it EVEN once.
I think that's probably a legitimate 10.
 
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  • #10
Pain is an inherently subjective experience and may fall into the hard problem of consciousness in neuroscience. Therefore constructing a precise and consistent objective pain scale is difficult, maybe even impossible. The best we can do is what others have mentioned, subjective scales and indirect measures. The latter may involve vital sign monitoring, grimacing, infant crying and such but are not very sensitive or specific and are useful in tracking individual progress through treatment. So you can't exactly claim that two people giving a 5/10 pain rating as having he same amount of pain, but you can be more confident that a person who presents with a 9/10 rating which progresses to a 3/10 is on the right track.

Not only can two people give different ratings to similar stimuli but the same stimulus may elicit wildly different responses in an individual at different times. There is the phenomenon of CNS sensitization after acute or chronic pain, for example. You can read a little about it here: http://www.medscape.org/viewarticle/481798

For a pretty good, and fairly comprehensive, read you can check out book(s) by (David?) Butler, I think the one I have read is called Explain Pain.
 

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