The best pain scale...

...doesn't exist.

Pain scales are steeped in controversy, and the opioid crisis has heated the conversation to a roar, with patients and researchers yelling past each other rather than collaborating. This isn't surprising, given that the people who care most about pain (those living with it) may not be capable of dispassionately discussing it. And unlike tumor size or joint mobility, clinicians can't measure pain, challenging their confidence in treating it. 

And yet, a symptom history is the patient's area of expertise. Only patients know their pain, and clinicians depend on them to accurately characterize and report it. But that can be hard for patients to do. And when patients do journal their symptoms, clinicians may dismiss their work as evidence of hypochondria.

So how should we parse these mixed messages?

First, we must accept that the experience of wellbeing and pain are unique to each patient. What matters is how it manifests and evolves, not proving that it's real. Equally important is respecting how each individual manages that pain and what is lost because of it. This is something Symple must do better. Now that we can import activity and sleep data, can we see how wellbeing or pain impacts our daily life? How might we include these insights in our Doctor's Report? Would it improve our care?

natasha gajewski