As a classically trained dentist, one of the first things I ask a patient in discomfort is to describe the quality and amount of pain. I often get answers like "sharp", "throbbing", and "dull" describing the character of pain they are experiencing. As a follow-up, I often ask: "on a scale of 1 to 10, 10 being the worst, how is the pain?"
Well, new research described in this Globe and Mail Article has shown that this one value approach may be missing up to 1/3 of patients with enough pain to affect their daily lives. The better approach is to rate their current pain, their highest and lowest levels of pain over the previous week, and the level of pain they endure most of the time. After reading this article, I've changed my methodology and will encourage my collegues to do the same.
Here's a teaser quote from the article:
It may be a painful truth, but a new study suggests that attempting to measure pain on a scale of 0 to 10 may not help doctors effectively treat the suffering.
The findings, published in the October issue of the Journal of General Internal Medicine, claim the commonly used numeric rating system failed nearly a third of the time to identify patients whose pain was serious enough to impair their day-to-day functioning.
Researchers attributed the results to the subjective nature of pain, the reluctance of some people to admit their suffering, the propensity of others to exaggerate, and limiting the scale to measuring patients' current pain level.
Source: Globe and Mail Online Edition Sept 18/07; Pain ratings fail sufferers
Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)