Pain can be notoriously difficult to describe, as almost everyone who has ever been asked to will know. At a recent medical visit, my doctor asked me to rank my pain on a scale from 1 to 10. I found it incredibly difficult to do. A 10, she said, meant “the worst pain imaginable,” which brought back unpleasant memories of having appendicitis.
A short while before the problem that brought me in, I’d broken my toe in two places, which had hurt like a mother—but less than appendicitis. If appendicitis was a 10, breaking a toe was an 8, I figured. If that was the case, maybe my current pain was a 6. As a pain score, it didn’t sound as bad as I actually felt. I couldn’t help wondering if I might have given a higher score if my appendix were still intact. I wondered, too, how someone else with my medical issue might score their pain.
In truth, we all experience pain in our own unique ways. Pain is subjective, and it is influenced by our past experiences, our moods, and our expectations. The way people describe their pain can vary tremendously, too.
We’ve known this for ages. In the 1940s, the anesthesiologist Henry Beecher noted that wounded soldiers were much less likely to ask for pain relief than similarly injured people in civilian hospitals. Perhaps they were putting on a brave face, or maybe they just felt lucky to be alive, given their circumstances. We have no way of knowing how much pain they were really feeling.
Given this messy picture, I can see the appeal of a simple test that can score pain and help medical professionals understand how best to treat their patients. That’s what is being offered by PainChek, the smartphone app Deena wrote about. The app works by assessing small facial movements, such as lip raises or brow pinches. A user is then required to fill a separate checklist to identify other signs of pain the patient might be displaying. It seems to work well, and it is already being used in hospitals and care settings.