4 Problems With The Pain Scale

My life has been filled with a lot of pain and many different types of pain. In the past 7 years, I have not had a single day without pain- not one. I have good days and bad days, but even the good days are filled with pain. Aside from the pain itself, the pain scale is one of the banes of my existence.

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1. It Doesn’t Work For Chronic Pain

Not only is it a pretty terrible scale for measuring pain in the average person, but it is even less effective for people with chronic pain.

I’ve had a lot of people when talking about pain, make the comment “but you’re used to it.” This isn’t exactly true. My pain is actually worse and more unbearable than it has ever been before. Pain doesn’t hurt any less because you are used to it. What you really get used to is living with it. You get used to pretending you don’t have pain, using coping methods such as distraction, and hiding the pain.

If I had the average response to dislocating a joint that the average person did I would be crying, distorting my face, and screaming far too often to navigate this world. So I’ve learned to breathe through it and even smile. Only people very close to me can even tell that something is happening- and often they can’t even tell. Developing this coping mechanism is so necessary for living with chronic pain and such a problem at the doctor’s office.

I have had at least a dozen kidney stones. The pain of a kidney stone is slightly worse than my average Ehler’s Danlos pain, but not enough that I can easily shed my coping mechanism of hiding my pain. One night I began to pee blood and couldn’t keep fluids down so I went to the ER. I told them I had a kidney stone- I know full well what they feel like by now. The nurse told me I couldn’t have a kidney stone, “Even giant footballer men roll into the fetal position from kidney stones.” They did a scan and, of course, I had a large kidney stone. I eventually got treatment, but first was told I wasn’t in enough pain. It was infuriating and it has happened more than once.

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It has gotten to the point where I almost feel like I have to try and visibly show the pain I feel inside, but it is still so difficult.

2. It Isn’t Standardized

Another problem is the scale means something different to everyone. I’ve been told 10/10 is the worst pain I’ve ever felt and also told that 10/10 is the worst pain I can imagine. These are far different measurements! For the same pain, I would rate it as a 8 on the first scale and a 3 on the second (I can imagine some horrific pain).

3. We Can Only Compare Pain- Not Imagine It

Generally, we can only rate our pain based on comparisons to other pain we have actually felt. That is the best way to understand someone’s pain. However, many people are at the extremes- they have either had a fairly pain free life or have experienced immense pain. Two people’s 7/10 may be wildly different. The scale does not work as a stand-alone tool without considering the pain patients have felt in the past.

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4. The Scale Is Used Against Patients

Another problem with the pain scale is that it is commonly used by nurses and doctors against the patient. If you answer too high on the pain scale and they can’t see the cause of your pain, they will assume you are lying to get drugs. If you answer an 8 and then check messages on your phone (even though distraction is one of the best solutions to pain) they will assume you are lying. If you answer too low they won’t take you seriously. Instead of using the scale to help treat patients it is often used to hurt patients.

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So if the pain scale is the problem what is the answer? Medical professionals need to listen to their patients when they describe their pain and take a look at their medical history. The pain scale needs to be taken with a grain of salt when used and needs to be standardized. Medical professionals need to make up their minds. What is a 10/10? Decide and then stick to it!

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The Big Problem With Overdose We Are Forgetting

 

Everyone is freaking out about opiate overdose- what about the major problem no one is talking about?

Prescription overdose has been in the spotlight lately, which makes sense. Drug overdoses have now surpassed automobile overdoses as the leading cause of accidental death. What doesn’t make sense is that because of this spotlight chronic pain patients are running into a harder time getting the help they need. Instead of addressing drug abuse and overdoses in a productive manner people are punishing chronic pain patients who need help by making it harder to get their medication.

This study reveals that chronic pain patients aren’t the ones who are having problems with abuse; Only 2% of chronic pain patients end up having problems with abuse. However, if people make conclusions based on the media, all chronic pain patients are addicts destined to accidentally overdose.

Overdose is heavily talked about, but there is one extremely important aspect to this that everyone is missing- suicide. Dealing with pain every second of every day can, unsurprisingly, be incredibly depressing. In fact, 19-28% of people with chronic pain are suicidal on some level, whether through suicide ideation or with actual plans to carry out their death. And the most common tool for suicide in these cases? You may have guessed it- medication overdose.

We need to change how we perceive health and chronic pain for this problem to go away. Two major risk factors in chronic pain patients who commit suicide are patients feeling like a burden and not feeling like they belong. This comes as no surprise to me. Our society absolutely treats people who are disabled like burdens and outsiders.

We praise the people who are friends with/ dating/ supporting chronic pain patients because we see chronic pain patients as burdens instead of people.

We abuse chronic illness patients at a rate that is 1.5 times the usual or 4 times as much if the chronic illness is mental, only to act like they are lucky to have anyone in their lives.

We do the bare minimum to make things accessible (only because it is the law) and act like we are doing disabled a favor.

We treat people with chronic pain first as criminal drug-seekers and consider their pain and quality of life second.

We talk about how terrible opiates are and how they are never justified. There is no understanding that for many of us the choice is between this unfortunate drug and killing ourselves because the pain is too much to live with every day.

We often go out of our way to avoid the disabled. We look away or make an excuse.

Overdose is a huge issue and it should be taken seriously. However, going after people who are already hurting is only going to worsen this issue and cause an increase of overdoses. Researchers already don’t feel like they can properly tell which opiate overdoses are accidental or suicide. Statistics suggest that we should at least consider that suicide is a big issue in the discussion on overdose.

Part of the solution is to change the way we think about and treat chronic pain patients. 

Another part of the solution is to change the way we think about and treat chronic pain patients. The other is to make naloxone, a medicine that can save people from  an overdose, easily available to people who do overdose accidentally.

Decriminalising these drugs would also help drug abusers get the help they need without fear of being charged with a crime. 

When we talk about overdoses we often leave out discussions of the people who are using these drugs the most. We also need to make the increase in suicide, abuse, depression, anxiety, and PTSD in chronic pain patients part of the conversation on increased overdose.