A New Way To Objectively Measure Pain

Ed Normand

Attorney
(866) 735-1102 Ext 336

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A difficult issue in the presentation of a personal injury claim is whether the victim is truly in pain and if so how much? This is especially true in cases with non surgical injuries or "subjective" injuries that cannot be seen or proved by diagnostic tests like an x-ray or MRI. In these cases, often the only proof of the pain is the patient's testimony that they are in pain. In fact, the sole and primary element of many injury claims is a "pain and suffering” claim. Many times jurors will reject the pain and suffering claim outright because they are reluctant to award money without objective proof of the pain. Now a new test may be used to objectively quantify the existence of and degree of pain that someone is experiencing. If the test is valid it can provide an objective basis to satisfy the skeptics and prove that one is, indeed, experiencing pain and suffering.

The new test called Patient-Reported Outcome Measurement Information System(PROMIS) is a computer program using a series of questionnaires to provide a standard to measure and rate the pain. The program purports to provide a standardized scoring system to rank the type and intensity of pain in a comparison of the attributes and symptoms of pain. More importantly, the program can be used to quantify the impact that the pain has on the activities of daily living. It can also provide a measure of how the pain level responds to various treatment modalities. Thus, if the system works, it can validate not only the fact that the pain is real but that future medical care costs should be awarded to mitigate the pain. In a personal injury case the tool could be used to show that future care costs shoud be awarded to pay for treatment modalities such as physical therapy that have resulted in a reduction of the pain.

Some problems that may develop from the use of the system are that it still may be entirely subjective despite the standardized scoring and rating system for pain. The questionnaire asks for responses to questions such as: Does the pain cause nausea? Does the pain make you tired? Does the pain limit your ability to do certain listed activities? Without a measure of the truthfulness of the responses the test may just substitute subjective testimony about the pain and its effects for subjective responses to a questionnaire about pain. In that case, it may really offer nothing new to the heart of the issue--whether or not the pain is real or imagined.