![]() Given that pain is a universal human experience, researchers continue experimenting to determine what pain is - including how the body experiences and communicates about it. ![]() “If I’m in a very anxious state, or I’m feeling relaxed, I might be paying different attention to my pain, which might make it feel very different,” Atlas notes. ![]() This subconscious decision is influenced by many factors, she says, including stimuli from physical harm (such as a slipped vertebra) interoception, which is how a person senses what is happening in their body overall (such as hunger and warmth) and one’s emotional and psychological states at any given time. “I view pain as a decision-making process,” says Lauren Atlas, PhD, chief of the Section on Affective Neuroscience and Pain in the National Institutes of Health’s Intramural Research Program. Part of the mystery is that pain is more than biological - psychological, emotional, and social conditions influence how each person experiences it at any given time. “There are many things we still don’t know about pain.” “We think about pain as being caused by one thing, but often it’s not that simple,” Goertz says. That report notes that chronic pain (generally defined as pain lasting more than three months) is “one of the most common reasons that adults seek medical care,” and links it to anxiety, depression, opioid dependence, restrictions in mobility and daily activities, and reduced quality of life.Ī core challenge in assessing chronic pain is that pain is not a stand-alone ailment it is the body’s response to other developments, including injury, infection, and disease. adults (nearly 52 million people) report feeling chronic pain, according to survey results published in April by the Centers for Disease Control and Prevention. Yet doctors need to get the picture somehow: Twenty-one percent of U.S. “That measure alone is not sufficient to really understand what the patient is experiencing,” says Christine Goertz, DC, PhD, professor of musculoskeletal research at the Duke Clinical Research Institute and director of system development and coordination for spine health in the Department of Orthopaedic Surgery at Duke University in North Carolina. Many doctors and patients find such pain measuring tools okay for a superficial start but ultimately inadequate for assessing chronic pain to a degree that informs effective treatment. The doctor tries to help: On a scale of 1 to 10, does the level of pain feel like a 2 (mild), a 6 (severe), a 10 (worst possible)? Look at this series of emoji faces: When it hurts, do you feel like the face that’s expressionless? Frowning? Crying? “Pain is a very personal experience and hard for a lot of people to put into words,” says Erin Krebs, MD, MPH, chief of general internal medicine at the Minneapolis VA Health Care System and a professor at the University of Minnesota. They worry about minimizing the pain, which could mean it doesn’t get sufficiently addressed, but also about overstating the pain, which could make them come off as exaggerating. During just about any doctor’s appointment with a patient who complains of pain, there comes an awkward moment when the doctor asks a seemingly straightforward question: “How badly does it hurt?”
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