Main Question or Discussion Point
What is pain threshold?
Can pain be measured? If so, how? What are the units?
Can pain be measured? If so, how? What are the units?
If you ask a woman giving birth, your pain will never ever be a 10.Also - Triage staff in clinics sometimes will ask you to evaluate your pain, from 1 to 10, with 1 being slight pain and 10 being the worst ever.
As already alluded to, in many medical situations, we use a scale of 1-10 (there are no units). We ask the following question of our patients (Pts): "On a scale of 1-10, with 1 being very little pain, and 10 being the worst pain you've ever felt in your life, how would you rank this pain?"Can pain be measured? If so, how? What are the units?
Mythbusters did an episode on it and swearing did help them tolerate pain longer, IMHO I think vocalization of any type if done with intensity would tend to help, 1. its a distraction, 2. if said with enough intensity it may release more adrenalin into the blood stream.As for people making excessive fuss, perhaps there is some sense in it. I have seen reports of research showing that tolerance of pain is increased by shouting and swearing
Nerve conduction I also find as inadequate measure of both pain and muscle response, I was given a test and it measured the conductivity of the nerves in my legs. On the right side which is the side most affected I couldn't even feel nor did I even flinch as these long needles were pushed into my leg and then electricity was applied to measure the amount of conductivity. Although sometimes my pain on that side is excruciating it varies between tingling, burning, aching and numb. The test said the nerves were working...lol Then they tested the left side which I felt and the test was horrible, the left side came back slightly abnormal even though every time they shocked me I nearly jumped off the table. On the right side the feeling is so diminished at times I don't even have "reflexes" or the Dr, just can't find it, which with the test being "normal" I found very odd.Anyway, skin conductanse reseponse (both frequency and tonic level) are one way to _measure_ pain, but it's an unspecific measure. It measures rather sympthatetic activity, which can be triggered by things other than pain.
I think this is about the most accurate ranking you're going to get if it's dealt honestly by the patient. Junkies will always walk in the office and say it's 9.5 everytime because of drug-seeking behavior but every one of them knows the real number."On a scale of 1-10, with 1 being very little pain, and 10 being the worst pain you've ever felt in your life, how would you rank this pain?"
That can also apply to someone in sever pain, many ER docs and GP's forget that in (some cases not all) that if an honest person can deal with a pain or take care of it themselves they will, that's what Ibuprofen, Tylenol, Aleve are for. SO when they do go to Doctors or the ER is because they are SEEKING drugs. For relief not for getting a fix. IMHO a way of distinguishing from those types of patients (chronic pain sufferers and legitimate patients in sever pain) from (junkies and druggies) is required. Many people are sent from the Doctor's or ER or Walkin-clinic with prescriptions they can get over the counter,( Ibuprofen, Aleve ) then they are left with an outrageous bill for basically first aid advice and the equivalent of a home remedy, its a shame that a few bad apples can spoil the bunch.say it's 9.5 everytime because of drug-seeking behavior but every one of them knows the real number.
One technique we use in EMS that sometimes helps when a patient is complaining of pain from an injury, is to palpate the injury in a way that the patient can't see what we are doing. We may gently palpate it a few times, usually eliciting an "ouch that hurts", and then we fake touching it again and ask "does that hurt?". We sometimes get another "ouch that hurts" answer, which helps us to understand that at least part of the pain that is being reported is not real. This only works in some situations, but it's a useful tool that we do take advantage of sometimes.BTW what is a good way of distinguishing a patient in true distress from a junkie or druggie?
I guess my point about the slippery slope and the OP's question is that, once you've had the taste of opiates, introspective reports about the level of your pain pretty much just go right out the door. The introspective report is obfuscated. The bottom line is that you have endogenous pain killers that do the job just fine in all but the most extreme cases. There are a lot of ex-junkies that get into serious accidents and have significant pain and refuse meds and they do just fine.I think anyone going to a doctor seeking pain meds should be drug tested first.
Weird, Vicodin is a very mild pain killer compared to oxcycodone and oxcycontin. I have been on oxcycodone on and off for over 40 years and have never become dependent on it. If I'm in bad pain, I take one, if I'm not, I don't take one. For years, I would go for months, even years without any, then need them and take them until I no longer needed them. For the past few years I have needed them, but I manage to deal with the pain and only take 5mg daily to maintain my sanity because the doctors get so much grief for prescribing them. I really need more, but I'll manage with the 5mg for now just to not be going crazy from the pain. I guess that I am one of those people that don't have addictive personalities. Someone once said I should be studied.Painkillers are a slippery slope. I had a friend back in the 80's that was an ex-junkie porn star who was clean for 3 years when he had a moped accident and woke up in the hospital knocked up on dilaudid. He never got off of it again and became a methadone maintenance casualty. I had a broken bone x-ray recently and was grateful they didn't prescribe me an opioid narcotic. What would I have done if I got a script for vicodin, say? IDK, I don't want to know. I haven't done that stuff in years but I was hooked at one point. If you're a junkie or an ex-junkie, it's hard to turn it down.
Wow that's such a wrong thing for a supposed specialist to think about his or her field.... I'm like flabbergasted that a doctor could be operating under that kind of assumption concerning their own patients. There are definitely some chronic pain sufferers who are just faking it but no one believes they are close to a majority. And that they don't take you seriously as a patient unless you put on the whole dog-and-pony show? That doctor sounds pretty aweful honestly. (At least you sound like you're satisfied with your treatment for the most part so that's good!)Seems like I wasn't taken seriously until I showed up in the Dr. office in full uniform. But as the doctor has explained to me it seems there are more of them (,junkies and druggies) then there are of us.