Pain Scores: are they damaging us?

shoulder-pain-osteoarthritis

Are ‘Pain’ scores damaging the public’s health!

 

Ever been asked to score your pain out of 10?

Ever been asked to describe your pain and even draw a picture of where it is?

Ever wondered why?

We are taught to believe that a description of our pain and its intensity will help us to find out what’s wrong. This approach has grown in popularity, in part fuelled by a trend in cultural expectations that we should be pain free. In part driven by commercial practice that attempts to sell a ‘pain free’ lifestyle. It is both tempting and financially lucrative.

So does this approach work?

No. The number of people with long term pain is rising, mental ill health associated with pain is rising, the financial cost for the management of long-term pain is increasing and the health of the nation is decreasing. 

So why is it that a standard medical consultation spends time discussing a persons experience of pain and how it affects them?

There are several reasons, the key ones include:

  • All NHS contracts in orthopaedics stipulate that outcome measures based on pain scores are put in place as part of service contracts. Consequently, the clinicians have to ask and patients have to score high in order to gain access to care.
  • It is cheaper to talk about pain than it is to investigate.
  • Many clinicians are taught to ask about pain and there is trend in becoming more empathetic as opposed to diagnostic. ‘How do feel’ has gained priority over ‘this is what’s wrong’. 

Is this pain discussion really that bad?

At its current level, yes. As a consequence of our focus on ‘pain’, our time and financial resources are being spent on ‘pain’ driven pathways instead of appropriate investigation and medical intervention. The focus on ‘pain’ is like having focus on the noise a fire alarm makes. The alarm is not the real problem, the alarm is a warning. It is the resultant investigation that determines if there is a problem and if so, where it is and how big it is.

Side note: Veterinary practitioners have the luxury of avoiding the whole pain score and pain discussion because animals don’t speak. Veterinary clinics have ultrasound scans, x-rays, some even have MRI’s. Many have blood laboratories on site and as a result our pet animals have immediate focus on ‘what is wrong’. 

So, if we don’t measure ‘pain’ what should we do?

Firstly, we should make a tissue based diagnosis to determine the nature of the problem. Then we should deliver treatments that are backed by research.

Corrections to posture, alignment and strength, including surgery; all help improve body mechanics.
Corrections to chemistry within our bodies will always promote health.

If we stop chasing pain and start chasing after best health, then our healthcare resources will be used to improve the health of the nation. 

Book an appointment to find out what is causing your pain

If you are in pain but don’t know what tissues are damaged or irritated, then a physical examination enhanced by ultrasound is a great place to start. It costs £75.

Book your initial consultation including ultrasound scan 

www.injectionclinic.co.uk

Author: admin

Chris Creaghan is a chartered physiotherapist and specialises in musculoskeletal pathology. With a sporting history Chris remains focused on the attainment of best health. Enhanced skills include ultrasound sonography, biomechanical analysis, guided injection therapy and over 20 years of experience in differential diagnosis. Chris is familiar with NHS and private care and has developed numerous clinical pathways to facilitate both cost savings and seamless integration of care.

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