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Needs way to measure pain besides the scale of 1-10

By Keith Roach, M.D.

DEAR DR. ROACH: Why is pain measured by numbers? I have severe pain, and doctors do not know what to do when I say it is an 11 on a scale of 1-10. My pain can’t be measured by numbers. It depends on the time of day, what I have done during the day and the weather.

I have arthritis in most of my joints, specifically my spine and hips. Having had five spine surgeries, epidurals and hip shots, I have pain every day. There is not much more that can be done but to take opioids. It can be hard to make the decision either to take an opioid and go out shopping or for coffee feeling like I am in a vacuum, or to go out in pain.

There is no chronic pain support group in my area, and no one can understand how I feel, even the professionals, unless they have gone through it. So when asked how I am, I say “fine.” Other people don’t want to hear about my pain.

Why is there not another way the doctor can measure your pain? I have given up everything I love to do in life because of pain. There’s no way to get “better” from pain. -- M.L.D.

ANSWER: I am very sorry to hear your story, as it is similar to those I have heard before from people with chronic pain due to many different causes. It is disappointing for me to hear that you haven’t found a pain specialist in your area who seems to care about helping you.

Although the 1-10 pain scale is thoroughly entrenched, it has its flaws. The biggest one is that what one person might consider a two, another person might consider a nine. I’ve seen people with horrifying injuries gritting their teeth and saying their pain is a 3 while other people claim their pain from what seems to be a minor condition is a 10 (I had one person tell me the pain from getting his blood pressure taken was a 10). Because pain is subjective, there is no way of standardizing what a person means with their pain rating. However, a 10 on a scale of 1-10 is supposed to be the worst pain imaginable.

DEAR DR. ROACH: My father, 90, has neuropathy in his feet and legs, and it is very painful. He recently talked to a clinic that is offering stem cell treatment to relieve the pain. The clinic says it helps 85% of those who get the treatment; however, because of HIPAA laws, they don’t provide any referrals.

The treatments are very expensive ($16,000), and results are seen in six weeks to six months. Are you familiar with this treatment, and is it effective for most people? Is this something you can recommend? -- D.B.

ANSWER: I also have seen advertisements for stem cell treatments for many conditions. For neuropathy in particular, there are no good studies that give an estimate of effectiveness. It may be the case that 85% of people treated at the clinic report improvement. But the risk of a placebo effect is very high with this kind of procedure, and I could not recommend stem cell treatments for neuropathy without better information about the risks, the benefits and how long those benefits might last.

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to

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