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Computerized Pain Charts Should be Redesigned to Properly Explain My Pain

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Every time I go to the chiropractor I am welcomed by a computer’s voice. Then a pain chart pops up with questions to help me locate and describe my pain. This particular “welcome” irritates me on good days and makes me feel unhinged on bad ones. Although I haven’t seen all of the different types of pain charts, I know the computerized ones don’t work for me. I either fill it out halfway, or I skip it altogether.

Pain is obviously not my favorite sensation, but I know I need to pay attention to it, learn about it and communicate it effectively to get the help I need. I know pain is my body trying to talk to me.  

But charts don’t look at pain as having value.

Our bodies speak to us in the language of sensation. Lyme disease ups that communication level and intensity because pain and inflammation are a common topic for those of us who have it. An empathetic person listening to me explain my body’s latest pain revelations makes a lot more sense to me than trying to describe it with the touch screen of a computer.

Much of your pain is the bitter potion by which the physician within you heals your sick self. — Khalil Gibran

Here are some of the issues I have with computerized pain charts:

  • I prefer to interact with people when describing my pain. Looking someone in the eye when I talk about my pain drives me to be more honest with them and myself. I don’t feel empathy or acceptance coming from a computerized pain chart.
  • I never receive a copy of the pain records from the computerized chart.
  • Lyme pain generally doesn’t fit into a standard box. My chiropractor’s chart segments pain based on little sections of your body. My Lyme and the pain of many others is on the move. One day my hip hurts, and the next day it’s my elbow in pain. It can easily take 10 loops to cover all the areas, which is why I skip it.
  • Pain charts don’t deal with inflammation at all, and it is as important for me to track inflammation as it is to track pain. There is no way to put down swelling, edema or discoloration on these pain charts.
  • There is no scale explanation for the chart. Instead, I use my general understanding, and I don’t know if I am interpreting the pain levels correctly. I always doubt if I am under-reporting or exaggerating my pain nagging me.
  •  I have had joint and muscle pain for years. To me, these charts don’t seem to have much to do with anything that I find valuable.
  • Pain is personal and hard to quantify. couldn’t explain the pain I was feeling to my husband who knows me better than anyone else, let alone to a doctor I see for 15 minutes or less. Trying to describe pain within the perimeters some computer programmer created does not work for me either.

With all that said, this is how I would redesign a pain chart to help both the patient and their doctor:

1. The patient would get a copy of each pain chart.

2. The doctor would review the chart and give suggestions to address the noted symptoms.

3. The pain chart would ask if the patient is using rest, ice, compression, elevation and/or anti-inflammatory medications.

4. The patient will have the option to fill out the pain chart with a healthcare practitioner.

5. The computer touch screen or paper form would allow the patient to draw out pain in a fluid process that shows location area of influence and direction.

6. The pain chart would give explanations for the pain rating system that applies to daily life. For example, an 8 would indicate I can’t do anything and can hardly think of anything else besides pain.

7. The pain chart would include inflammation, swelling and nervous system signs of pain.

8. The pain chart would allow the patient to check off joint, muscle, organ or soft tissue as well as draw the location.

9. The pain chart would use colors as part of the rating system.

What is your take on computerized pain charts? Would you add anything to make a pain chart more efficient?

Photo credit: Alexey Bezrodny/Getty Images

Originally published: August 17, 2018
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