The intersectional implications of a quantitative epistemology in pain care and research

Abstract

Background: There is a growing interest in understanding the long-standing tension between subjective experience and objective measurement, with a focus on better understanding personal or lived experience. However, quantitative pain measurement is itself a complicated practice that is rarely examined. The method does not exist in a vacuum but along a historical trajectory that we believe to be worth unpacking. Aims: We seek to highlight (1) the problematics associated with a systemic reliance on quantitative tools that are themselves validated via statistical methods; (2) what alternatives already exist, regardless of their logistical shortcomings; and (3) the actual and possible consequences of continuing a trajectory of data-based pain rating. Methods: We present historical and contemporary case studies through theoretical frames that help the reader understand the social construction of pain as a phenomenon whose quantification has been justified with statistical approaches. Results: Relying on quantitative data for a pain rating that is perceived as more valid, reliable, and efficient—a triad that has come to represent the ideal pain measurement instrument—risks entrenching both patient/participant and clinician/researcher in systems of computation and control. This is detrimental to society’s most vulnerable populations. Conclusions: Patients, practitioners, and social scientists all have an opportunity to reframe their understanding of pain measurement as medical practice to build more equitable spaces in pain medicine.