Pain is what you feel
This simple statement is obvious on the face of it. But it has implications that are not necessarily as obvious. The first of which is: The only pain you can be sure of is your own. A corollary to this is: You are the only one who knows your pain, with certainty. Knowing about someone else’s pain is like knowing what someone else is thinking. Sometimes, you have a very good idea based on the way they are behaving. Sometimes they will tell you outright, and you feel you can believe them. But you cannot know about someone else’s pain the way you know about your own pain.
In biomedicine, there have been many attempts over the years to develop an “objective measure of pain." This has been something of a holy grail in pain medicine for decades. Given that clinical and scientific observations inform us about behavioral and physiological events that are related to pain, there is an expectation that some set of behavioral and/or physiological measures can definitively measure pain in any given individual. Examples of such attempts include measuring facial expressions, electromyography (electrical signals from muscle activity), electroencephalography (EEG — electrical signals from brain activity), and most recently, functional neuroimaging approaches such as positron emission tomography (PET) and functional magnetic resonance imaging (FMRI). These approaches only produce an approximate indicator of an individual’s pain. Even what a person tells you is only an indicator, not definitive. As such, we are forced to accept some level of uncertainty about another person’s pain, just as you must accept some uncertainly as to knowing what another person is thinking. And some people are good at concealing or disguising the pain they experience (as well as their innermost thoughts). This state of affairs makes it harder for a medical provider to try to help someone with their pain in the same way that one might help, for instance, with their fever.
We recommend the following resource for additional information:
The Chronic Pain Research Alliance
