As I lay here, not sit but lay because of pain, for the last 27 days, I am compelled to write down some of my observances about the nature of pain. In fact, I’ve not been able to sit, stand, or walk without excruciating pain I never knew existed since April 4th. That’s saying something as I’ve had my share of health issues and surgeries. But the pain from a herniated disc causing pressure on my sciatic nerve root is beyond what I’d ever imagined. Surprisingly, my back hasn’t been sore for weeks, it’s all in my left leg. The sciatic nerve is actually a joining of several spinal nerves from L4 and down to S3. This means it has roots between lumbar 4 and 5 as well as sacrum 1, 2, and 3. These nerves join together on either side of the spine heading into the legs forming the sciatic nerves which enervate or send nerve signals to each leg. When the nerve root of part of the sciatic nerve is under pressure, it can cause a myriad of symptoms, not the least of which is terrible pain.
All this brings me back to my topic this month: how do we describe pain? Most of use a 1-5 or 1-10 scale for pain where one is very little or no pain and 5/10 represent horrible pain. When I was a child, it was explained to me as the worst pain ever. However, since I’ve become an adult, other physicians have described it as simply unbearable pain. This scale can be useful, but it is vastly incomplete. I finally realized why and want to share my thoughts with you.
I hope it is helpful, but that you never have to use it.
So, I don’t think we need to do away with the pain scale, but I do think we need to add two more scales as well as have a better vocabulary for describing pain when we need to. I propose adding a volume and an attitude scale to the mix.
Volume Scale:The volume scale was my first realization. Like irritating music, when it’s not too loud, it can be tolerated. However, when the volume is very high, it can become unbearable to be around. It is the same for pain. Even though pain can be at an 8, it can be handled if it isn’t too “loud”—where it isn’t the only thing you can focus on. The numbers don’t matter, but I recommend using the same scale we use for pain.
The second scale is the attitude scale. Even when the pain and it’s volume are high, it can be better tolerated when we are happier. Yes, pain makes us unhappy, and chronic pain can lead to depression, but our attitude is flexible and we do have some control over it… mostly. So I propose a scale focused on mental/emotional endurance is a useful addition to more accurately describe pain.
How would these be used? Well, I’ll use myself as an example. Currently, as I lay here and feel sore from being bedridden so long, my physical pain level is at a 5 out of 10. However, the volume is only about 3 out of 10. So I’m not as focused on the discomfort. Add to that, my attitude is pretty good at an 8 on my scale from 1-10 (10 being good on only this scale—on the others, higher is worse). So, I’m doing pretty well. To contrast, earlier my husband and I tried to go to see my chiropractor. The pain of walking and sitting was unbearable and we didn’t make it out it out of our neighborhood before we had to turn around. By the time I was back in bed, I was sobbing from pain. At that point, my pain was up to an 8, the volume was 10, and my mental/emotional state was a 2.
Can you see how this would be helpful to let your doctor or physician know so s/he better understands your situation? I know it will be helpful with my clients in my practice. If you come see me to work on anything painful, expect to use these three scales so we can fully understand and explore your individual needs.
Finally, we don’t often have a strong vocabulary for pain adjectives. These can be extremely helpful, especially in homeopathy.
|· Aching||· Beating||· Binding||· Biting|
|· Blinding||· Blunt||· Boring||· Burning|
|· Caustic||· Cold||· Comes & goes||· Constant|
|· Cramping||· Crushing||· Cutting||· Dragging|
|· Drilling||· Dull||· Electrical||· Excruciating|
|· Flickering||· Freezing||· Gnawing||· Heavy|
|· Hot||· Icy||· Intense||· Intermittent|
|· Jumping||· Knot-like||· Nagging||· Nauseating|
|· Niggling||· Numb||· Penetrating||· Piercing|
|· Pinching||· Pins & needles||· Pounding||· Pressing|
|· Pricking||· Pulsing||· Radiating||· Rasping|
|· Raw||· Scalding||· Scratchy||· Searing|
|· Sharp||· Shocking||· Shooting||· Sickening|
|· Smarting||· Sore||· Splitting||· Spreading|
|· Stabbing||· Stinging||· Stretching||· Sudden|
|· Suffocating||· Superficial||· Tearing||· Tender|
|· Throbbing||· Tight||· Tingling||· Tiring|
|· Tugging||· Unbearable||· Unrelenting||· Wrenching|
Hopefully, when I write more next month, I will be sitting again! As always, if you need help, don’t hesitate to schedule an appointment today.