Health and Fitness

Words Matter

Today I read a great article published by NPR discussing how we as physicians and patients talk about a pain. In short, “words matter”.

It is much more beneficial to talk about activity and function. What is your comfort level and what are you able to do.

The much-maligned pain rating scale in which we ask patients to rate their pain from 0 to 10, has been shown to be very ineffective. Although it is an ordinal scale. There is frequently no logical association with the number given by the patient and their actual pain level. Multiple psychosocial factors play into the number given by the patient

The pain rating scale was used back when we referred to pain as the fifth vital sign. This had the unintended consequence of focusing too much on pain. It is much more beneficial to talk more about functions, not feelings. As an example, patients may be asked to report what the pain prevents them from doing. From there, patients are asked to report what they are able to do. In this way, we can slowly change the focus to increased comfort and function and decreased emphasis on pain.


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