In a new study from the University of Rochester, researchers found along with the 0-10 rating scale, asking the question “Is your pain tolerable?” could help doctors decide if treatments, including opioid medications, are actually necessary.
Because of concerns about overtreatment of pain with opioids there has been an enormous effort to rethink how people ask patients about pain.
In the study, the team asked 537 patients at 157 primary care practices in the Western New York region to rate their chronic pain using the 0-10 numeric rating scale (NRS) and also respond yes or no to the question: “Is your pain tolerable?”
They found that almost 4 out of 5 patients in the primary care setting who rated their pain as “moderate” in intensity found it tolerable and as many as 30 and 40% of people who rated their pain as “severe” (a score of 7 or more) also described the pain as “tolerable”.
The numeric ratings are very good at detecting change from one moment to another in an individual patient, for example as the patient recovers in a hospital after surgery.
But they may have “very little relevance” when patients who have lived with chronic pain for several years visit their doctors for periodic checkups.
The team says knowing that patients consider their pain to be tolerable, physicians wouldn’t necessarily prescribe a medication with serious risks or expose them to surgery.
Instead, it could be an opening for a clinician to explore mood, sleep disruption, or the curtailing of certain activities to control pain.
If you care about pain management, please read studies about common opioid painkillers may increase pancreatic cancer risk and findings of can depression drugs help reduce chronic back pain and osteoarthritis?
For more information about pain and your health, please see recent studies about a new way to treat chronic pain without opioids and results showing that this diet may increase your risk of low back pain.
The study is published in JAMA Network. One author of the study is John D. Markman.
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