“On a scale of one to ten, with one being the least and ten being the most, how much pain would you say you’re in?”
Chances are good that if you’ve been to a doctor during your lifetime, you’ve had to respond to this question at some point. The pain scale and accompanying wincing-face drawings have long been a main tool, along with physician observation, in determining exactly how much a particular patient is hurting. But while time-tested, this method has the potential to be inaccurate. Almost everyone handles pain in different ways -- some have a higher tolerance than others, and some people respond differently to certain pain treatments than others. Currently, no method exists that doctors can use to determine beyond a shadow of a doubt exactly how much someone is hurting or what kind of pain they’re in. And even if there were, would it be able to distinguish one patient’s pain from another’s?
Enter Dr. Julia Finkel, a pediatric anesthesiologist based in Washington, D.C. who has developed an experimental device that tracks reactions in the patient’s pupil to light and non-painful stimulation of particular nerves. While the device is still in development, and Dr. Finkel and her team are still seeking FDA approval, the hope is that this device or one like it will eventually be able to help physicians determine not only how much pain a patient is in, but what the best way to treat that pain is. Maybe a patient is experiencing a kind of pain that would be better treated with a drug that simply numbs the person’s perception of the pain instead of a drug that actually stops the physical transmission of pain from nerves to the brain.
How important would it be to the field of medicine to develop an objective way to measure pain? What are the challenges in trying to boil down the complexity of pain to a single measurement?
Brent Yeung, M.D., assistant professor of clinical anesthesiology at UC Irvine; he worked with Dr. Finkel
Shalini Shah M.D., associate clinical professor of anesthesiology and director of pain management at UC Irvine Health
Lynn Webster, M.D., former president of the American Academy of Pain Medicine and author of the book “The Painful Truth: What Chronic Pain is Really Like and Why It Matters to Each of Us” (Oxford University Press, 2016)