Self Imposed Barriers Inhibit Pain Relief For RA | Arthritis Information

http://www.medicalnewstoday.com/articles/142822.phpgood article Joonie.....

(tried to send you a PM but you're box is full)

I have always thought that the way pain is described causes the biggest problem. People have different perceptions, and the way pain scales are described causes problems as well. Depending on the scale you have in your head, somebody else might think you are a wuss or a baby, or somebody who is really tough. A "3" isn't the same to everybody, or each dr. I like the last scale as it describes mentally how you feel as well. This is the one my dr. has hanging in his office. He says that patients will often say they are at a 9 or 10 pain wise and then he has them look at the descriptions and the level drops considerably. Of course, if they have another appointment with another dr., the lower number might make them seem better off than they really are.

0 = No pain
1 = Mild pain
2 = Discomforting
3 = Distressing
4 = Intense
5 = Excruciating

0-1 No pain
2-3 Mild pain
4-5 Discomforting - moderate pain
6-7 Distressing - severe pain
8-9 Intense - very severe pain
10 Unbearable pain"

Comparative Pain Scale
	0	No pain. Feeling perfectly normal.
Minor Does not interfere with most activities. Able to adapt to pain psychologically and with medication or devices such as cushions.	1 Very Mild	Very light barely noticable pain, like a mosquito bite or a poison ivy itch. Most of the time you never think about the pain.
	2 Discomforting	Minor pain, like lightly pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails. Note that people react differently to this self-test.
	3 Tolerable	Very noticable pain, like an accidental cut, a blow to the nose causing a bloody nose, or a doctor giving you an injection. The pain is not so strong that you cannot get used to it. Eventually, most of the time you don't notice the pain. You have adapted to it.
Moderate Interferes with many activities. Requires lifestyle changes but patient remains independent. Unable to adapt to pain.	4 Distressing	Strong, deep pain, like an average toothache, the initial pain from a bee sting, or minor trauma to part of the body, such as stubbing your toe real hard. So strong you notice the pain all the time and cannot completely adapt. This pain level can be simulated by pinching the fold of skin between the thumb and first finger with the other hand, using the fingernails, and squeezing real hard. Note how the similated pain is initially piercing but becomes dull after that.
	5 Very Distressing	Strong, deep, piercing pain, such as a sprained ankle when you stand on it wrong, or mild back pain. Not only do you notice the pain all the time, you are now so preoccupied with managing it that you normal lifestyle is curtailed. Temporary personality disorders are frequent.
	6 Intense	Strong, deep, piercing pain so strong it seems to partially dominate your senses, causing you to think somewhat unclearly. At this point you begin to have trouble holding a job or maintaining normal social relationships. Comparable to a bad non-migriane headache combined with several bee stings, or a bad back pain.
Severe Unable to engage in normal activities. Patient is disabled and unable to function independently.	7 Very Intense	Same as 6 except the pain completely dominates your senses, causing you to think unclearly about half the time. At this point you are effectively disabled and frequently cannot live alone. Comparable to an average migraine headache.
	8 Utterly Horrible	Pain so intense you can no longer think clearly at all, and have often undergone severe personality change if the pain has been present for a long time. Suicide is frequently contemplated and sometimes tried. Comparable to childbirth or a real bad migraine headache.
	9 Excruciating Unbearable	Pain so intense you cannot tolerate it and demand pain killers or surgery, no matter what the side effects or risk. If this doesn't work, suicide is frequent since there is no more joy in life whatsoever. Comparable to throat cancer.
	10 Unimaginable Unspeakable	Pain so intense you will go unconscious shortly. Most people have never experienced this level of pain. Those who have suffered a severe accident, such as a crushed hand, and lost consciousness as a result of the pain and not blood loss, have experienced level 10.

rocckyd2009-07-05 18:27:36 This is a good graph
Bodak2009-07-05 21:49:23bump..

Nice graph, Rebecca! I think I will use that to help me determine my pain levels from now on. I have a hard time determining which "number" I am. I usually downplay my pain levels anyways. I just figure let people guess at it by looking at my face LOL!

Well... I kinda like the pain scale on my RDs door. It is of faces. While waiting for her I try to decide which face repressents me. Most times I am the 2nd frowny face from the crying face. But I have been there and been the crying face.

I think it is intresting that childbirth is considered an 8 at that scale. Kinda puts it in perspective....You know when I was really bad off and had no meds, but the 5mg of pred. I always said I would rather give birth than go thru the pain I was going thru. But I lived thru it, and now my pain is much less.

By that chart I am normally between 5,6, & 7, when I am not doing well.

Right now... I am a 2 & 3, and I am not taking daily tramadol or muscle relaxers.

Right now I would say I am a 4. But, when the chest flares up periodically during the day-that would be a 6. I have had to pull over while driving until it passes.

Pain is now one of the vital signs they monitor in the ER. Still, there is just no accurate way to explain it. Plus, when people see a diagnosis and if they have something similiar-they think they know your pain. Ex: as you guys know, I had the bilateral jaw surgery in Feb. Everybody and there brother has TMJ issues-and I heard all about it. Um....not quite the same folks. When people describe RA pain, everybody has joint issues. I know there are people with OA that have horrible pain-these aren't the people I am talking about. It's the guy whose shoulder hurts cause he just played 18 holes of golf. Just not the same type of pain. When I see my pain dr, I look around the waiting room. I remember one lady who was yelling at the receptionist that she needed to see the dr.(she had no appt.) cause she was out of her pain meds. She was screaming that she hurt at a 10(and many other curse words). Of course, she did not get to see the dr. and security was actually called. This woman, at a 10, was able to shove a security guard, kick a chair, and fight the whole way out. Must be nice.....

I am sorry you have those chest flares, Rebecca. I hope the Drs at Duke can fix that problem for you when you get to see them later this month.

Much hugs to you.

Ok... so I have to amend my pain scale. I answered this when I first woke up this morning and was not thinking.

When I am not doing well... I am a 5-8. But mainly probably just a 6 most of the time, until the pain gets to me, then it just goes up the scale from there.

Interesting article, especially this statement..."However, two-thirds said they were satisfied with their pain management and 8 in 10 believe pain can be effectively controlled."

I'm sure if we took a poll on this board, it would be a lot less than two-thirds who would answer that they were satisfied with their pain management. But then again, this board is probably representative of people that are not well controlled, hence the need for a support board. I imagine most whose RA is controlled or in remission do not have the need for a support board.