Can the pain of a fracture, renal colic and childbirth be compared to determine which one a person endures more heavily? In the 1980s, Canadian psychologist and pain researcher Ronald Melzack tried to do this. This was reported by Qazaqyia.kz citing Kursiv Media.

His work became one of the early attempts to measure pain not only on a scale from 0 to 10, but also to take into account how exactly a person feels it.

Melzack, together with American psychometrician Warren S. Torgerson, developed the McGill Pain Questionnaire. In it, the patient did not simply rate the pain, but chose words that most accurately described the sensations: for example, "burning," "shooting," "pressing," "dull," "exhausting" or "unbearable."

The researchers collected more than 100 words that people used to describe pain, and then grouped them by meaning and intensity. In the final version of the questionnaire, 78 descriptors remained, divided into groups.

Each selected word corresponded to a certain score. The sum of these scores formed the PRI — the pain rating index. The higher it was, the more intense and severe the pain was considered within this method.

In a work published in 1984, Melzack separately examined pain during childbirth. Together with colleagues, he studied how physical and psychological factors influence its intensity.

Among the conditions with the highest indicators were:

For comparison, in the same table, pain after injuries received approximately the following indicators: bruise — 22, fracture — 20, cut — 18, laceration — 17, sprain — 15 points.

But the authors emphasized that one cannot confidently say that one pain is worse than another. Pain is a subjective experience influenced by many factors.

Melzack's work became an important stage in the study of pain, but its results cannot be used as an exact list of the most painful diseases.

Firstly, a limited set of conditions participated in the comparison. It did not include many diseases and pain syndromes that are considered very severe.

Secondly, not identical situations were compared. For example, pain after an injury is an acute condition, while phantom pain or some types of neuralgia can persist for months and years.

In addition, the measurement method itself has limitations. The questionnaire assesses how a person describes their pain. There is no device that measures its "strength."

Later, conditions appeared in research that were not in Melzack's old comparison.

For example, cluster headache. In a 2021 study, 1,604 people with cluster headache rated its intensity on a scale from 0 to 10. The average score was 9.7 points, with 72.1% of participants giving the maximum 10 points.

For comparison, in the same study, the average pain score during childbirth was 7.2, for pancreatitis — 7.0, and for kidney stones — 6.9 points.

Another condition is trigeminal neuralgia. In a study of 158 patients, 58% of participants rated attacks of shooting pain at an average of 10 out of 10. Even ordinary actions such as chewing, touching the face, brushing teeth or talking could trigger an attack in many.

Modern publications also discuss complex regional pain syndrome (CRPS), central post-stroke pain and pain after spinal cord injury. Some of these conditions received very high ratings in previous studies.

It turns out that medicine does not have a single rating of the "most terrible pains," but there is a list of conditions capable of causing especially intense pain.

Earlier, Kursiv Health wrote a joint material with a neurologist about central sensitization — a condition when pain "becomes fixed" in the nervous system and becomes chronic. The doctor explained why it is dangerous to endure pain.

If the article causes you anxiety, discuss it with an artificial psychologist.