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To Feel or Not Feel Pain

When seeking relief from illness or injury most of us have been asked by a healthcare practitioner to rate our pain. Usually referring to a rating scale of 1-10.

We are beginning to learn that although better than nothing this scale may not tell the true story of how each individual feels pain.

Writing for The New Yorker magazine author Nicola Twilley, who was going to subject herself to testing, was told by the scientist. Irene Tracey,  who directs Oxford University’s Nuffield Department of Clinical Neurosciences and has become known as the Queen of Pain. “We might have a problem with you being a ginger,” she warned. Redheads typically perceive pain differently from those with other hair colors." 

There is a difference too, between pain threshold and pain tolerance. And this is subjective and highly influenced by our culture.. Now that researchers can see the brain while willing participants are subjected to painful stimuli, there is beginning to be a clearer sense of how we perceive pain. Many things can affect how we perceive pain, researchers have shown that holding a loved one's hand can help a person tolerate more pain. We know mindfulness training and biofeedback help people to ease chronic pain. 

As research brings us a better understanding of how individuals perceive pain and we strive to use fewer opiates for pain, we can assist doctors as patients by learning how to better communicate our feelings of pain. 

Recently Patti Neighmond reported for NPR. "Words Matter When Talking about Pain to your Doctor"  that Dr. John Markman, director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry, said " The numeric pain scale may just be too simplistic if your doctor gets the wrong idea about your pain, it's not just going to affect your comfort — it can affect your treatment. Especially after an injury, there's therapeutic value to keeping the pain tamped down so that you can keep up with physical therapy." 

The question Markman now asks his patients is, "Is the pain tolerable?" Three-quarters of the patients who rated their pain between 4 and 7 on the numerical scale, a range that typically calls for higher doses of medications, also described their pain as "tolerable" — a description that normally means no more pain treatment is needed.

"This showed the danger of relying only on a number, "Markman said.

The best advice when communicating with your doctor is: 

Get descriptive: use metaphor and memoir 

Describe your day

Talk about function, not feeling

Share your treatment history

 The more detail you can share about how you perceive and tolerate pain the more you will get the treatment that will truly ease your pain. 


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