Here Is How We Should Change The 'Pain Number System' in Healthcare

“To me, 10 is dead.”

We need to change how we talk about pain.

“I’ll never say a 10,” I tell the doctors, after my normal examples of ability to tolerate pain - from diving back in to work, to opening nights with aching livers - “To me, 10 is dead.”

I rarely say above an 8… But most of my nurses have said that men are most likely to say 10 when it’s likely not a 10 (sorry dudes, just reporting data I’ve collected) and that most people who are feeling a real 9 or 10 would be unable to say so because that’s how bad it would hurt.

That’s exactly how I look at the number pain system too.

“It hurts to sit up,” I’ll say as my reply, instead of saying 5 or 6-with-conditions or 8-but-not-really.

“I’m whatever number it is where it’s hard to sit up.”

THAT is what I wish we could change the pain system to… because pain itself (whether men being more likely to say 10, or someone like myself looking way too calm at an 8) is subjective.

“Can you drive yourself?”

“Can you bare down to go to the bathroom?” (No, not Number Two. Just Number One. Because sometimes it hurts too much to do that. If you don’t know that, you don’t know that number of pain yet, thankfully.)

“Can you roll over at night unassisted, or do you have to grip and grab at a fitted sheet?”

And so on.

Pain isn’t what our face shows… it’s how it impacts our day.

How can we revise it by looking at the spectrum of our personal-mobility-rainbow?

We all sit up differently, for example.

Some of us can’t at all… so we’d define it by how we hold our head and neck that day, versus the more traditional ‘waist right-angles’. But, the end concept is still the same:

How can we show pain not by how we “show” it… but how we feel it?

And, most of all, how does feeling that pain show up in how we live our actual day?

Because when those everyday dignities are impacted - no matter how differently we might navigate the world from someone else…

That’s when pain becomes so much more than a sad-cry face on a graph, taped to a wall.

PART ONE.

Continued tomorrow….

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