Join Lesley Singer in discussing One Thing she wants pain researchers or clinicians to know. Lesley challenges the over-reliance on the 0-10 pain intensity scale. She advocates for understanding the whole person, considering pain bothersomeness more than pain intensity, and building strong clinician-patient relationships.
About Lesley
Lesley Singer is a physical therapist and a patient advocate. She is also an educator at McGill University. developed chronic pain after spinal surgery in 2004. You can find out more about Lesley here.
Transcript
Joshua Pate: What is one thing you want pain researchers or clinicians to know?
Lesley Singer: I would like clinicians to know that it’s more important to hear my story than to worry about all the forms you need to fill out and be more concerned with objective measures of my pain. So, asking me what my pain is on a scale of 0 to 10 really infuriates me because what difference does it make if my pain is 4 / 10 but it really really bothers me, then it’s more important than if it’s 8 / 10 but I’m okay with it. And sometimes it can be like that. Sometimes it can be 4 / 10, but it’s been 4 / 10 for the past 5 months and it never changes. So it’s more important to ask me how much my pain bothers me on a scale of 0 to 10, rather than “what is my pain?”. Because It alters, it changes, it changes with the time of day it changes with what I’ve been doing, what I might have eaten, with what I might have done to help me deal with the pain. And so when you don’t ask me all those questions, a number is just a number. And for me a 4 / 10, what does that mean to you when you’ve asked a dozen other people who’ve said 4 / 10, and it means something totally different to them.
I’m a physiotherapist, so I know I’ve asked people that many, many times myself. but when I became a patient, I can honestly say I sat outside that room, and because I’m a clinician I knew they would ask it, and I must have spent a good solid 20 min of stress wondering what number I should give in order for them to think It was important enough for them to see me. But yet not be exaggerating enough that they say, “well, she just catastrophizes.”
Really, I think therapeutic alliance is what it’s all about. And so you develop that with your patient as a clinician and when you have that alliance they’ll be able to open up to you. And you’ll be able to tell them you don’t know all the answers, but together you can look. And I think that is the most important thing, and if you have a therapeutic alliance they will open up and tell you their story.
Joshua Pate: Excellent! Well, thank you again for your time. We really appreciate it.
Lesley Singer: Okay, it’s been nice meeting you.