Asking patients to rate their pain on a scale from zero to 10 is "a simple but baffling request," Elisabeth Rosenthal, MD, wrote in a July 2 opinion piece for KFF Health News.
Dr. Rosenthal, a senior contributing editor at the news outlet, previously worked as an emergency room physician in New York City. She said she has asked that question thousands of times, but years after transitioning to journalism, Dr. Rosenthal wrote that she picks a mostly arbitrary number to answer the same inquiry.
To quantify "sore hips, the prickly thighs, and the numbing, itchy pain near my left shoulder," she said she answers with three or four, "knowing the real answer is long, complicated and not measurable in this one-dimensional way."
Pain fluctuates, as do the answers to a subjective scale.
Feelings of discomfort can dissipate during busy times of focus, or they can worsen with changes in mood. Plus, a "10+ pain can be bearable when it's endured for good reason, like giving birth to a child," Dr. Rosenthal said.
In the 1970s, the zero-to-10 scale grew in prominence, and 20 years later, a "pain revolution" swept through healthcare as the opioid crisis began. The "fifth vital sign," a phrase copyrighted by the American Pain Society, was soon tracked alongside blood pressure, temperature, heart rate and breathing rate.
In the decades since, the industry has reckoned with the danger of overprescribing opioids, but measuring pain remains a tricky task. Multiple healthcare organizations and agencies have questioned whether pain could be accurately and numerically reported by a patient.
Read more here.