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Random thought about Medics and asking 'how bad is your pain from 1-10

(38 Posts)
KriticalSoul Tue 20-Feb-18 00:00:48

I was watching one of the ambulance programmes earlier, and it got me thinking when they mentioned some people say their pain is a 10, but their obs don't reflect that, but some people you can TELL they're in severe pain.

Take me for instance, I've had 2 bouts of kidney stones/renal colic, two children, one of which was born without any pain relief as she arrived too quickly, I've also had tattoo's and broken bones, burned myself and suffered a wisdom tooth abcess, I also have spinal degeneration that leaves me in low level constant pain.

Surely when I told the Triage nurse that I was at a '10' level of pain during my last kidney stone incident that needed some heavy morphine to relieve, that having been through all that kind of serious pain, my '10' is going to be a lot different from someone who's never experienced those levels of pain?

Someone who's at worse only had toothache, or stubbed a toe or sprained a wrist might rate their pain as a 10, as its genuinely the worst pain they've ever been in, whereas something like that might only rate a 4/5 for me.

EnidButton Tue 20-Feb-18 00:07:19

I've never understood it either. Surely pain is subjective. How can anyone tell what someone's '10' feels like.

There's a thing about women having a higher pain threshold too isn't there? (Might be wrong) So if a woman is saying her pain is 8-10 then surely it's safe to assume it bloody hurts!

EnidButton Tue 20-Feb-18 00:08:59

I stand corrected. Apparently it's men who have a higher pain tolerance. confused Who'd've thunk it?

Thisimmortalcurl Tue 20-Feb-18 00:10:17

It’s quite commonly used though isn’t it. No matter how subjective. I think I have quite a high pain threshold but if I’m at 10 I can’t speak.

KriticalSoul Tue 20-Feb-18 00:10:50

I find that an odd one, especially when you see the blokes they do the labour pain experiments on writhing around...

AssassinatedBeauty Tue 20-Feb-18 00:13:15

I thought it was meant to be subjective, for assessing whether pain relief is needed, and if it's getting worse or better.

brizzledrizzle Tue 20-Feb-18 00:15:14

Different pain affects people in different ways too, I find headaches intolerable but coped with gallstones pain when alone,of course it was excruciating but somehow more tolerable than the crushing nauseous headaches I get

Becca19962014 Tue 20-Feb-18 00:19:48

When last in hospital I was asked this, but the scale they use is one to three, with one being nothing and three the worst ever confused

When I said it seems pointless to me as surely each persons pain is individual to them I was told the patients point of view isn't really taken into account.

In my case I subconsciously now mask pain - think being sent for x-Ray and staff being shocked at damage seen and why I'm not showing it. The explanation is simply that I am terrified of hospitals and anyone medical.

Whwhywhy Tue 20-Feb-18 00:26:44

Well till they invent something better that’s all you can do. Unless we have everyone a standard injury at 18 as a baseline?

I’d like a fit bit like device that could measure pain or tiredness for the wearer. Would settle lots of arguments round here next time me and dh got sick at the same time.

“No I’m an 8 sore and 90% tired, you get up with the kids.”

greensnail Tue 20-Feb-18 00:26:49

As a one off measure it is pretty meaningless. I tend to use it to see how a patient's pain changes over time so you can assess what is helping and what isn't.

Smeaton Tue 20-Feb-18 00:27:29

Isn't of just a useful way to get patients to pause, take breath and think?
Someone with and injured leg screaming at the ambulance medoc that it hurts isn't very useful to the medic trying to find where it hurts. A direct question of where on a scale makes the patient think and respond with more accuracy and pin point the problem, it goes from 'My leg hurts' to 'My shin is a 7 and my thigh is a 9' iyswim?

Thisimmortalcurl Tue 20-Feb-18 00:29:44

I’m the same with headaches Z@brizzledrizzle I can’t deal with them at all . Had a few babies though and the last one I knew the midwifes didn’t think I was that far along cause I wasn’t speaking when I was 9 cm .
I think it’s cause I always think I’m having a brain hemmorage when I have a headache as I’m not used to having them.

SleepingStandingUp Tue 20-Feb-18 00:35:21

Its measures if pain is getting better or worse and it gives an overview as to how well the patient is coping. It doesn't matter if your 3 is my 10 because its not you in pain, its me. If I'm in pain and I cant cope with the level of pain I should get pain relief.

During labour they kept pushing me to use gas and air but I felt ok without it for the first few hours. They kept telling me I didn't need to be brave and to use it but I didn't feel it necessary.
When I had to go in to have a camera up my bum I sucked on that gas and air for all I was worth

halfwitpicker Tue 20-Feb-18 00:42:51

Also, there's pain, meaning localised pain, as in wisdom tooth pain and then generally feeling rough, as in having a kidney infection feeling rough.

Does that make sense?

Walkerbean16 Tue 20-Feb-18 00:48:34

there is nothing trivial about toothache!!!! I've had three babies without any pain relief, one was 10lb. last year I had toothache - it was the worst pain I have ever felt. I was on the floor in a and e crying and begging them to help me!

TheDishRanAwayWithTheSpoon Tue 20-Feb-18 00:58:36

It just gives a rough idea of how bad the pain is and whether the person needs painkillers or not. There's no other way to do it, pain is always going to be subjective.

Getting people to describe pain is suprisingly difficult and it's just a quick way of determining rough severity, other wise I find you tend to get either an I don't know or a long description of all the different types of pain a persons had and it can be take a long time and be very confusing. I also find that people will say they're in a lot of pain but will then say a 4/10 or something. It doesn't really matter if everyones 10 is different but for example no one would say a 10 for a bruise or a 1 for gallstones.

kateclarke Tue 20-Feb-18 09:21:29

Because we are taught that pain is what the patient says it is.
If the patient is in pain, it needs to be treated. It doesn’t matter if physiologically there should or shouldn’t be pain.

Velvetbee Tue 20-Feb-18 09:29:09

I came to write ‘pain is what the patient says it is,’ too.
A particularly arrogant registrar gazed disdainfully down at my elderly mum and said ‘You don’t look as if you’re in pain.’ I was speechless. My mum has stoically coped with chronic and episodes of acute pain for 40 years. If she says she’s in pain she’s in pain.

Butteredparsn1ps Tue 20-Feb-18 09:31:06

Pain assessment is complex, along with the patient's score the HCP will also ask about type, location relieving and aggravating factors, whether it is affected by moving or breathing in for example.

As PP says pain is what the patient says it is meaning it's their experience. If someone says they in in severe pain, we accept that as their experience, even when it is likely to be exacerbated by fear or anxiety as these too are genuine experiences.

As part of s detailed assessment say for chronic pain or terminal illness, the HCP may discuss the level of pain the patient chooses to put up with to avoid side effects of medication. This spectrum varies widely amongst individuals.

Ilovemalteaserbunnies Tue 20-Feb-18 09:31:46

I think that's the point though- pain is subjective and personal so medical care and pain control needs to reflect that.

TheCatsPaws Tue 20-Feb-18 09:40:12

I don’t get it either. I didn’t find a c section painful at all yet I’ve beeb told I’m exaggerating when I’m doubled over with period pain hmm

Surely if someone who’s up and walking normally after surgery is crying on the floor, you realise something is wrong.

Iceskatingsnake Tue 20-Feb-18 09:40:59

I’ve always wondered about this. It’s so subjective depending on pain threshold, emotional state etc. I guess with those who are non verbal the medics have to go by physical signs and obs. My pain threshold is very low so my 8 will be very different to someone with high tolerance to pain. I suppose it’s the best we can do at the moment.

Iceskatingsnake Tue 20-Feb-18 09:44:29

velvetbee as a health care assistant I looked after a very elderly patient with bowel cancer. If she said something was a bit uncomfortable you could be pretty confident that she was in significant pain. She was of the generation that gritted their teeth and didn’t complain. If she moaned a bit I took that to mean the pain was really bad.

LorelaiVictoriaGilmore Tue 20-Feb-18 09:47:48

Totally agree that it depends on emotional state too. Labour with my first baby hit the 6 out of 10 range only when I was in active labour; with my first baby I hit a 6 out of 10 in the early stages of labour because it was 2am, I had a cannula in both arms and I knew that I could start bleeding heavily at any moment. 🙁 The consultant obviously rolled her eyes a bit when I said 6 out of 10 so early on but it was more down to being terrified!

YassQueen Tue 20-Feb-18 10:22:08

It doesn't matter if it's a 3 for one person and a 7 for someone else. The point is, the 7 is struggling to deal with it so could use some pain relief, whereas the 3 is able to cope with it. The only person who matters in that moment is the person experiencing the pain.

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