Can Pain Be a Number?
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Pain scores on a zero-to-ten scale (‘zero is no pain and ten is the worst pain imaginable’) are frequently used in clinical practice, in research, and in assessment of treatment outcomes. They provide a means to depict pain as a number. Despite evidence that pain numeric rating scales are not reliable as screening tools, and have not improved pain management, their use has not decreased. Pain scores have become part of medical parlance, and, by extension, can also be used by people with pain to describe their own pain. As a doctor working in palliative care, I meet many people who are living with pain. An important part of my assessment includes a question such as ‘What is your pain like?’ or ‘How does your pain affect you?’ or ‘Can you please tell me about your pain?’ If people respond with a score, I now ask; ‘Do you find it useful to talk about your pain as a number?’ and ‘Do you think that number helps me to understand what the pain is like for you?’ By exploring perceptions of pain scores held by the people who experience pain, the broader dimensions of pain can be revealed, leading to better understanding, and potentially better pain treatment. This presentation details some of the responses that people gave, and discusses their relevance to understanding the meaning of pain.