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Plotting a Pain Scale

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Pain is a fundamental part of life, and often a very lonely part. Doctors want to understand their patients' pain, and we all want to understand the suffering of our loved ones. But pinning down another person's hurt is a slippery business. Is your relentless lower back pain more or less unbearable than my crushing headache? Problem is, pain is maddeningly subjective.

Producer Tim Howard introduces us to three attempts to put a number on pain in the hopes that we can truly understand another's suffering.
We begin with entomologist Justin Schmidt's globe-trotting adventure to plot the relative nastiness of insect bites and stings. Then, Paula Michaels, a professor in the History of Medicine at the University of Iowa, brings us back to 1948, to a well-intentioned but ultimately misguided attempt to demystify the pain of childbirth. And we end with a very modern, very personal struggle as non-fiction writer Eula Biss tries to rate her own chronic pain.

Produced by:

Tim Howard

Comments [10]

Roberto from michigan

Here's a pain scale I thought of. I am (somewhat) joking though. Give a subject some pain, like a pin prick. How many cc's of morphine does he need to no longer feel anything? Wait a few days to return to baseline. prick them with a larger pin. How much more morphine do they need to not feel that pain?

alternatively, a doctor could ask "can you fall asleep with this pain?" Though I know the ability to fall asleep is subjective as well. Seems like that could discern a difference between an annoyance and a problem.

Nov. 10 2017 12:07 PM
Matt from Maine

I'm sorry, I question your entire premise. Factors such as hyperventilation and pupil dilation are both quantifiable and proportionate indicators of pain. Or are they? Perhaps fear is the factor behind those indicators? Robyn from Maine sort of touched upon this point.
Thanks for the great podcast!

Apr. 27 2017 11:06 AM
Sharon H from California

Just listening to this episode now, and it makes me think about when I went to the hospital with my appendix about to rupture. I was unable to stand, and had to be carried into the hospital, but I still rated my pain at a 5. My boyfriend who was with me, said I should have said 9 or 10. The doctor got a good laugh when I explained that to me, a 10 was being mauled to death by lions and watching them start to eat you. Guess it really is all subjective!

Apr. 25 2017 10:28 PM
Celia from Chicago

Because pain is so subjective, I believe that a familiar context is necessary for a pain scale to be reliable. I am a clinically trained massage therapist and when I was in school my instructor compared a level 10 pain to experiencing a gun shot. Nobody in the class had experienced a gun shot, so I knew it couldn't be clinically useful. When I began practicing, I tried to put the 1-10 scale into a context my patients could relate to. When assessing their pain, I describe level 10 as an amount of pain that would prevent them from performing their normal activities of daily living. When treating them, I describe level 10 as an amount of pain that would make them want me to stop massaging that area.

Apr. 23 2017 01:53 PM
Richard Klein from Worcester, MA

I can't even really comprehend my own pain, once the pain has passed.

Apr. 22 2017 03:37 PM
Robyn from Massachusetts/Maine

I think you missed a very important point in the whole discussion of childbirth pain. When I was pregnant with my first child, I went to natural childbirth classes, and the instructor explained the mechanism of childbirth and the facts that - even though it was awesomely painful - the vast majority of labors occur without incident and the pain is a byproduct of the process but not necessarily an indication that there was anything 'wrong' happening - all that was actually happening was a very strong muscle contraction. So, fast forward a few weeks to my own labor, and for the first time in my life I experienced what I call 'pain without fear' - and it was intense, but very manageable. I went on to have 3 more completely natural birth experiences - completely drug-free, as well as colonoscopies and endoscopies while completely awake. If we take away the emotional underpinning (fear) we can reduce the magnitude of our pain. Obviously - there are reasons why our brains interpret sensations as painful - usually to protect us from danger!! But there are also experiences that our brain interprets as painful that are not 'objectively' very painful.. where is fear in your equation? and 'education'? I credit that long-ago childbirth nurse with giving me one of the best lessons of my life.

Apr. 22 2017 12:29 PM
Fran from Santiago, Chile


I would like to know the name of the song at the end of this segment.


Aug. 29 2014 11:12 AM
Megan Mabey from Ottawa

I really relate to not being able to describe pain and feeling like you're not being taken seriously.

I was having terrible chest pains; it hurt to breathe, to walk, everything. Finally my boyfriend forced me to go to the emergency room and they gave me two x-rays and a blood test. They told me I was being tested for blood clots. My blood test was inconclusive, so was given a blood thinner through my stomach and was sent home and told to go to the thrombosis clinic the next morning.. still in brutal pain. I went to the clinic the next day, I had more x-rays, a ventilation and perfusion scan. Still in pain, nothing was found. Finally they did an ultrasound on my legs and I was given the all clear to go home. My doctor told me my pain was muscular and to take Advil, even though I said I had been for almost a week, was 9/10 on the pain scale and was in tears from the pain. I took 3 days off work and finally a friend suggested acupuncture. I went the next day, I told her what I had gone through and she said "they really put you through the wringer". She placed needles across my collar bone for 20 minutes. After I was still in pain, but that night I was finally able to sleep. I woke up the next day 100% better, and I've had no re-occurrences.

May. 13 2014 02:36 PM

This is an hysterically funny/accurate depiction of a pain scale.

Sep. 03 2013 10:04 PM
Katherine Keena from savannah, ga

I was fascinated with your discussion of pain, especially in regards to childbirth. I feel like I have a high pain threshold. Iwas a childhood migraine sufferer, and when i compare notes, I know i bore lots of pain.
And no denying it, even in an easy delivery, labor is hard painful work.
But the measurement that stunned me was the so callled "urge to push". Urge seems like a word connotating some control...but what I experienced was an overwhelming muscular action in my body that I had no contol over. It was like an alien power took over my body.....urge such an understated word

Sep. 02 2013 07:34 PM

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