Pain doesn’t belong on a scale of zero to 10

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Pain doesn’t belong on a scale of zero to 10
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Over the past two years, a simple but baffling request has preceded most of my encounters with medical professionals: 'Rate your pain on a scale of zero to 10.'

KFF Health NewsJul 2 2024 Over the past two years, a simple but baffling request has preceded most of my encounters with medical professionals: "Rate your pain on a scale of zero to 10."

The concept of reducing these shades of pain to a single number dates to the 1970s. But the zero-to-10 scale is ubiquitous today because of what was called a "pain revolution" in the '90s, when intense new attention to addressing pain — primarily with opioids — was framed as progress. Doctors today have a fuller understanding of treating pain, as well as the terrible consequences of prescribing opioids so readily.

After pain doctors and opioid manufacturers campaigned for broader use of opioids — claiming that newer forms were not addictive, or much less so than previous incarnations — prescribing the drugs became far easier and were promoted for all kinds of pain, whether from knee arthritis or back problems.

A zero-to-10 scale may make sense in certain situations, such as when a nurse uses it to adjust a medication dose for a patient hospitalized after surgery or an accident. And researchers and pain specialists have tried to create better rating tools — dozens, in fact, none of which was adequate to capture pain's complexity, a European panel of experts concluded.

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