Why Ideology Is Guiding Pain Care, Not Science

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Came across this a little bit ago via someone in the disability community on Tumblr.

Why Ideology Is Guiding Pain Care, Not Science
April 19, 2021

By Roger Chriss, PNN Columnist

https://www.painnewsnetwork.org/stories ... management

The one thing that inhibits scientists in the development of effective pain relief is that there is no reliable method for objective measurement of pain -- it is all based on a patient's own subjective judgement, and not on a scalar value displayed on a calibrated instrument.  Examples:

• Location: "Where does it hurt?"
• Area: "Just one spot or is it spread out?"
• Trigger: "What do you think caused the pain?"
• Treatment: "What makes the pain better/worse?"
• Time-of-Day: "When does the pain usually occur?"
• Intensity: "On a scale from 0 to 10, how much pain do you feel?"
• Character: "Does the pain feel like aching, burning, pinching, stabbing, or throbbing?"

Note that depression may increase patients' perception of pain, and their ethics/morals may cause them to downplay the severity of their pain.

What doctors need is a non-invasive instrument that they can use to objectively measure a patient's pain -- a poineometer.  Such a device would drastically cut down on writing opioid prescriptions for people who do not need them, and likely increase the amount of proper treatments for pain.

I don't suffer from chronic pain issues (yet), but I have reasons to believe it's not unlikely that I will eventually.

My hope is that by then there will finally have been a breakthrough in non-addictive pain relief (and hopefully non-addictive sedatives / muscle relaxants too -- I could definitely use that already). Otherwise... Things don't look too promising.

Lots of docs automatically assume that if a patient has depression & complains of physical pain that the patient must be a druggie who is faking or that the pain is psychosomatic & all in their head. Having long-term physical pain can cause people to develop depression. Being gasslighted, dismissed, & screwed over by the medical profession can cause & increase a patient's depression, & being more depressed will increase the likelihood that the patient's physical pain will be written off & it's a vicious cycle that just gets worse. Some people with depression & physical pain can fairly easily get stimulants, sleeping meds, benzodiazepines, & marijuana prescribed by their psychiatrist or GP but they can NOT find a doc who will do anything for their physical pain other than tell them to take Tylenol. Some patients can literally get all that stuff for their depression but can NOT get any narcotics when they have their gallbladder removed. I fail to comprehend how all that stuff combined is considered sooo much safer than prescribing a depressed person any narcotics when they literally had an organ removed The medical community needs to advance a hell of a lot more with their understanding, research, & treatment for depression & physical pain & people who have both problems.

Amen! to that.


and it also doesn't help if you were diagnosed with depression and bipolar in 1982 and it wasn't until 2000-something that some medical professional finally went, "You aren't bipolar, never been bipolar, you're autistic; here's the evidence I see why ..."

Then add in having acquired fibromyalgia and ME/CFS at beginning of 2000s after they hit your Dad at beginning of 1980s.

Sometime in the last several years I went to ER for a serious attack of chronic muscle spasms in my back which usually center around a 1990s spinal injury.
Got the sense they were assuming I was a drug seeker and weren't much concerned about my body.

Then ...

Eventually ...

After a while ...

Doctor comes in, lifts gown to look at my back ...

About two seconds of silence, and then, "Oh."

In short order they were giving me an injection of some powerful stuff.

That's the thing, with so many doctors is has to literally be In. Their. Face. Obvious. before they even begin to be capable of grasping the concept.

Yeah, the spasms were severe enough the Doctor SAW them.

And all of a sudden they were something which required immediate intervention.

But ...

Because of a prior incorrect diagnosis, assumptions were made ...

without investigation or examination.

Remember boys and girls, doctors are really smart people who pay a whole lotta money to get the world's best education from other really, really, smart people.

(snork!)

(yeah, right)

(sure they are and sure they do)

(say, does it sound like doctors might no longer impress me?)

(and, yes, by the way, I am broadbrushing the entire lot of them)