Oh look, it's me.
More people need to understand this. My hips & knees are in constant stabbing pain. Unless I physically cannot put weight on them, I will still be doing stuff because life continues & shit needs to get done.
Actually, realistically, even if my leg won't bear weight, I find a way around it to get shit done.
This is part of why I think most pain scales are absurd. I found one at my pain management office that doesn't base the rating on physical activity, but on how much it invades your thoughts. They understand that I (and a lot of chronic pain patients) can physically function with high pain levels because we have to.
So the question for the scale becomes, is the pain just background noise? Does it intrude into active thoughts? Is the intrusion only when you do certain stuff, at random times, or constantly? Is it making it harder to focus than normal? Making it a bit tough to articulate in conversations? Is it overwhelming all other thoughts?
These are the types of questions that should be asked when dealing with a chronic pain patient in any setting. Doctors, nurses, and emergency room staff should be taught this & adjust their line of questioning if dealing with a patient who has a chronic pain condition.
Additionally, it should be specified as to if they are questioning a specific or new pain or if they are questioning overall day to day pain. If I go into my doctor with a migraine, obviously my answers will be specifically about the migraine. When I go to my monthly pain appointment, we are talking about my condition over the last month and then specifically my condition that day.
When you have sustained high levels of pain, you develop coping skills to deal with it because it's unacceptable to just lay down crying all the time. This is also poorly understood.
Example: I went to the ER because I had suspected that a fall had resulted in some sort of fracture or tear in my hip. It was more swollen than a fall usually caused, was discolored, & while I could put a bit of weight on it while heavily leaning on my cane, doing so for more than 5 minutes made me vomit. I was told that wasn't possible because if it was broken at all or even slightly out of place, I'd be sobbing & not putting any weight on it. I reminded them that I have vEDS with very unstable hips & that I'd broken every bone in the top of my foot multiple times without even knowing until I came in because of swelling, walking on it for a day or two beforehand. They looked skeptical. So I slid my other hip & my shoulder out of socket, ever so slightly but still noticeably. They still looked skeptical but said they'd do xrays.
Later a different nurse came in & asked how I managed a small hip fracture at my age. She remarked upon how well I handled the pain & asked if I had a chronic issue. I explained & she nodded, saying "yep. That'll do it."
We need more education about chronic pain. The impact it has on our bodies, our ability to cope, our ability to function, and our cognitive health/function. More studies need to be done about the short term and long term impact. Because having been in some level of pain for as long as I can remember, I assure you that there certainly is an impact. (RIP my photographic memory)
