Until We Have Biomarkers, Pain Will Continue to Be Subjective


Until We Have Biomarkers, Pain Will Continue to Be Subjective

If there is one thing that pain management doctors know universally, it is the fact that pain is an extremely complex beast of which we know very little. The pain experience is different from patient to patient. Furthermore, we have no biomarkers or scientific methods to measure pain. And until we do, pain will continue to be subjective.

A fascinating piece published by the BBC in April 2023 does an excellent job of explaining how individual bias influences both patient and doctor perceptions of pain. It is a very good read. If you do choose to read it, be prepared to look at pain in a different way. Also be prepared to face the reality that pain is one area in which doctors are not even close to being experts.

No Objective Way to Measure It

The pain medicine doctors here at Lone Star Pain Medicine are gifted, talented clinicians who do their very best to help patients live their best lives. Our doctors work extremely hard to stay abreast of all the latest diagnoses and treatment options. They are willing to think outside the box to help patients find effective relief.

All of that said, even the best pain medicine doctors face a daunting problem: there is no objective way to measure pain. As things currently stand, clinicians can only rely on self-reporting. They need to rely on patients describing the pain they feel while rating it on a scale of 1 to 10.

Bias is unavoidable without some sort of scientific measurement, and it impacts both patients and doctors. It affects:

  • how patients perceive their pain
  • whether or not patients perceive a more serious condition
  • how well doctors empathize with patients
  • whether or not doctors believe patient reports of pain.

So where does this leave us? For now, it leaves us in the position of patients and their doctors having to work together as best they can to find solutions. Unfortunately, the best solutions are often fleeting. This goes back to not having any sort of scientific test or pain-indicating biomarkers.

Researchers Are Working on It

While pain medicine doctors and patients work together to manage conditions like osteoarthritis and spinal stenosis, there are researchers working on finding biomarkers that could be utilized to measure pain. The BBC piece mentions a couple of them:

  • Genetic Markers – One possibility is a blood test that looks for certain genetic markers that researchers would expect to find when the body’s pain response is activated.
  • Brain Activity – Another candidate is brain activity. We know the sensation of pain is a brain response to signals transmitted by the central nervous system. So if those responses could be measured, perhaps they could be used as a measurement of pain.

Research into pain biomarkers continues despite the difficulty of the task. Finding actual biomarkers seems to be the easy part. The harder part will be matching those biomarkers to some form of static pain measurement. Unfortunately, coming up with a standard will still require tying the biomarkers to self-reporting.

We Are Here to Help

The Lone Star Pain Medicine team will be keeping an eye on the research into pain biomarkers. If scientists should ever come up with something concrete, it will change pain medicine from top to bottom. Until then, we are here to help patients in the Weatherford, TX area.

We invite you to visit our pain clinic for a comprehensive exam and consultation with one of our clinicians. We specialize in managing pain so that our patients can enjoy the full lives they want and deserve.

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