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Pain – Is it Subjective?

I was at my friend’s house last weekend, listening to a story about a recent trip to the mall. As she describes, she and her husband were waiting in a check out line when a shopper got upset about a return that wasn’t going through. As she was tell the story, her husband began to recount it differently. Then, as they both started debating about whose version of the story was right, I realized that even though they were present at the same event at the same time, they clearly experienced it differently. While this may be an extreme example, the truth is that everyone can and does create their own version of reality, based on their personalities or past experiences. The same can be said for pain.

When is comes to subjectivity and pain, the question is not if you are experiencing pain, but rather, how painful it is. This can be seen when comparing one’s painful experience to another person’s same experience. For example, on a scale of 0-10, stubbing a toe can rate as a two for one person, or it can rate as a five for another.  Are both people experiencing pain? No question about it, but the intensity of their pain becomes subjective, based on their own composition.

“Pain is absolutely relative, which can make it complicated to diagnose and treat,” says neurologist, Dr. Mahyar Okhovat. “I sometimes meet patients with conditions that commonly lead to debilitating pain, who express a lower pain rating than I would have assumed. Other times, I see patients who have no obvious physical signs of pain, but rate their experience at a nine or ten. This phenomenon stresses the importance of assessing pain with a variety of tools, so that patients can be sure that I have all the information I need to accurately diagnose their pain.”

One such tool, designed by the American Pain Foundation, is called the LOCATES scale. The LOCATES scale is more detailed than the standard 0 to 10 scale, and helps you communicate your pain experience more effectively to your physician. Print out the scale and bring it to your consultation:

L: Location of the pain and whether it travels to other body parts.
O: Other associated symptoms such as nausea, numbness, or weakness.
C: Character of the pain, whether it’s throbbing, sharp, dull, or burning.
A: Aggravating and alleviating factors. What makes the pain better or worse?
T: Timing of the pain, how long it lasts, is it constant or intermittent?
E: Environment where the pain occurs, for example, while working or at home.
S: Severity of the pain. Use a 0-to-10 pain scale from no pain to worst ever.

Pain management specialist and founder of PMIR, Dr. Alexander Hersel, states, “Pain is a complex experience that involves more than just the site of the pain. It is all encompassing of your body, mind and spirit. As a pain specialist, it’s important that my patients know that I understand their pain, and that communication between patient and physician is the key to a successful treatment plan.”

Regardless of how much your pain hurts, at Pain Management & Injury Relief, we know that your pain is real. By seeing one of our pain specialists, you can be sure that you will be properly diagnosed, and given a sustainable treatment plan to relieve your pain. Schedule an appointment today by calling (855) PMIR-MED. We can see you within 24-48 hours.

Written by Robyn Carey, community relations team member at PMIR Medical Center.

By Pain Management & Injury Relief

Pain Management & Injury Relief is a leading patient-centered pain management clinic in Southern California. Our goal is to help you achieve long-lasting pain relief. By utilizing the latest medical technologies and equipment paired with innovative procedures and treatments, our team can help you improve your quality of life.

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