tag:theconversation.com,2011:/us/topics/measuring-pain-5313/articlesmeasuring pain – The Conversation2022-09-16T05:16:33Ztag:theconversation.com,2011:article/1907432022-09-16T05:16:33Z2022-09-16T05:16:33ZWe may be underestimating just how bad carbon-belching SUVs are for the climate – and for our health<p>Australia’s love for fuel-hungry and fuel-inefficient SUVs is hampering our ability to bring transport emissions down. SUVs make up half of all new car sales last year, a National Transport Commission <a href="https://www.ntc.gov.au/light-vehicle-emissions-intensity-australia">report</a> revealed this week – up from a quarter of all sales a decade ago.</p>
<p>As a result, the carbon emitted by all new cars sold in Australia dropped only 2% in 2021, the report found. Sales of battery electric vehicles tripled last year, but still make up just 0.23% of all cars and light commercial vehicles on our roads.</p>
<p>In internationally peer-reviewed <a href="https://www.transport-e-research.com/_files/ugd/d0bd25_5ccb87ff39e545809bd1f92872e3069a.pdf">research</a> earlier this year, we measured the emissions of five SUVs driving around Sydney, and our findings suggest the situation may actually be worse than the new report finds. </p>
<p>The National Transport Commission’s numbers are based on the “New European Drive Cycle” (NEDC) emissions test. Our research found the real-world emissions of SUVs are, on average, about 30% higher than the NEDC values. This means we are not reducing fleet average emissions by a few percent per year, but actually probably increasing them by a few percent every year. </p>
<h2>What the report found</h2>
<p>The transport sector is responsible for <a href="https://www.dcceew.gov.au/sites/default/files/documents/national-inventory-report-2020-volume-1.pdf">almost 20% of Australia’s emissions</a>, ranking third behind the electricity and agriculture sector. The first year of the COVID pandemic only reduced transport carbon dioxide emissions by about 7%, compared to 2019 emission levels.</p>
<p>Overall, Australia’s pride in carbon-belching transport is evident by the fact transport CO₂ emissions have risen 14% between 2005 and 2020. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-labors-new-tax-cut-on-electric-vehicles-wont-help-you-buy-one-anytime-soon-187847">Why Labor's new tax cut on electric vehicles won't help you buy one anytime soon</a>
</strong>
</em>
</p>
<hr>
<p>SUVs are generally larger and heavier than other passenger cars, which means they need quite a bit more energy and fuel per kilometre of driving when compared with smaller, lighter cars.</p>
<p>Although SUV sales are <a href="https://www.theguardian.com/environment/2020/aug/03/ban-suv-adverts-to-meet-uk-climate-goals-report-urges">rising globally</a>, the Australian fleet is unique due to its large portion of SUVs in the on-road fleet, often with four-wheel-drive capability. </p>
<p>According to the National Transport Commission report, sales of four-wheel-drives and utes surged by more than 43,000 in 2021, while large SUV sales rose by around 25,000. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1570228921081409538"}"></div></p>
<p>Rapidly shifting to electric cars is an important way to bring emissions down. But the report found in 2021, just 2.8% of Australia’s car sales were electric. Compare this to 17% in Europe, 16% in China and 5% in the United States. </p>
<p>In Australia, there is still no option to buy an electric ute, and electric vehicles remain <a href="https://theconversation.com/why-labors-new-tax-cut-on-electric-vehicles-wont-help-you-buy-one-anytime-soon-187847">prohibitively expensive</a>. </p>
<h2>Measuring SUV emissions in Sydney</h2>
<p>There are a <a href="https://www.transport-e-research.com/_files/ugd/d0bd25_041d08e4653743f5a4416f79fe1dbc13.pdf">range of methods</a> scientists use to measure vehicle emissions. </p>
<p>One popular method worldwide uses so-called “on-board portable emission monitoring systems”. These systems are effective because they enable second-by-second emissions testing under a variety of real-world driving conditions on the road. </p>
<p>On the other hand, the New European Drive Cycle (NEDC) emissions test is conducted in the laboratory. It was also developed in the early 1970s and reflects unrealistic driving behaviour, because test facilities at the time could not deal with significant changes in speed.</p>
<p>We fitted five SUVs with a portable emission monitoring system and drove them a little over 100 kilometres around Sydney in various situations, such as in the city and on the freeway.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=594&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=594&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484833/original/file-20220915-1807-7cahyp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=594&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Testing on-board emissions from SUVs in Sydney.</span>
<span class="attribution"><span class="source">Robin Smit</span></span>
</figcaption>
</figure>
<p>We then compared our measurements with the <a href="https://www.greenvehicleguide.gov.au/">Green Vehicle Guide</a> – the national guide to vehicle fuel consumption and environmental performance, which is also based on the NEDC test.</p>
<p>Our measurements of fuel consumption and CO₂ emissions were consistently higher. This varied from <a href="https://theconversation.com/the-road-to-new-fuel-efficiency-rules-is-filled-with-potholes-heres-how-australia-can-avoid-them-188814">16% to 65% higher than NEDC values</a>, depending on the actual car and driving conditions. </p>
<p>On average, real-world fuel consumption and CO₂ emissions were both 27% higher than NEDC values. Importantly, this gap has increased substantially from <a href="https://www.transport-e-research.com/_files/ugd/d0bd25_00dcaa41d8d046d3a7b84a65a2135bb7.pdf">about 10% in 2008</a>.</p>
<p>Indeed, <a href="https://www.transport-e-research.com/_files/ugd/d0bd25_00dcaa41d8d046d3a7b84a65a2135bb7.pdf">previous research</a> from 2019 found fleet average greenhouse gas emissions for new Australian cars and SUVs has probably been increasing by 2-3% percent per year since 2015, rather than the reported annual reduction by, for instance, the National Transport Commission. </p>
<p>This detailed analysis showed a sustained increase in vehicle weight and a shift to the sale of more four-wheel-drive cars (in other words, SUVs) are probably the main factors contributing to this change. </p>
<h2>More bad news for SUVs</h2>
<p><a href="https://www.transport-e-research.com/_files/ugd/d0bd25_041d08e4653743f5a4416f79fe1dbc13.pdf">We also recently</a> summarised the results of various emission measurement campaigns conducted in Australia and compared them with international studies. These include results from a study of vehicle emissions in a tunnel, and a study of vehicle emissions measured on the road with remote sensing.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=273&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=273&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=273&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=343&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=343&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484846/original/file-20220915-6106-1t3tkh.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=343&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Measuring vehicle emissions with remote sensing in Brisbane.</span>
<span class="attribution"><span class="source">Robin Smit</span></span>
</figcaption>
</figure>
<p>We found modern diesel SUVs and cars or diesel light commercial vehicles (such as utes) in Australia and New Zealand have relatively high emissions of nitrogen oxides and soot – both important air pollutants. </p>
<p><a href="https://www.mdpi.com/1660-4601/18/1/254">Around 2,600 deaths</a> are attributed to fine-particle air pollution in Australia each year. Transport and industrial activities (such as mining) are the main sources of this. </p>
<p>And in 2015, an <a href="https://nespurban.edu.au/wp-content/uploads/2018/11/CAULRR06_SubmissionFuelQualityStandardsAct2000_Mar2017.pdf">estimated 1,715 deaths</a> were attributed to vehicle exhaust emissions – 42% more than the road toll that year.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-rapid-shift-to-electric-vehicles-can-save-24-000-lives-and-leave-us-148bn-better-off-over-the-next-2-decades-190243">A rapid shift to electric vehicles can save 24,000 lives and leave us $148bn better off over the next 2 decades</a>
</strong>
</em>
</p>
<hr>
<p>The <a href="https://www.transport-e-research.com/_files/ugd/d0bd25_fc46b0a0b8ec45a0ae1ab01499e145d4.pdf">remote sensing emissions data</a> suggest 1% of one to two-year-old diesel SUVs and 2% of one-to-two year old diesel light commercial vehicles have issues with their particulate filters, leading to high soot emissions. </p>
<p>These percentages are high when compared with a <a href="https://ee.ricardo.com/news/remote-sensing-demonstrating-diesel-particulate-f">similar study</a> conducted in the United Kingdom, which could not find any clear evidence of filter issues.</p>
<h2>Three ways to move forward</h2>
<p>Ever increasing SUVs sales are a drag on successfully reducing Australia’s total greenhouse gas emissions. So what should we do? </p>
<p>Of course there are several things to consider, but in terms of fuel efficiency and greenhouse gas emissions, we believe there are three main points.</p>
<p>First, we need to make sure we have realistic fuel use and emissions data. This means the National Transport Commission and Green Vehicle Guide should stop using the NEDC values and shift to more realistic emissions data. We acknowledge this is not a simple matter and it requires a lot more testing. </p>
<p>Second, <a href="https://www.mdpi.com/2071-1050/14/6/3444">we need to</a> electrify transport as fast as we can, wherever we can. This is crucial, but not the whole solution.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-road-to-new-fuel-efficiency-rules-is-filled-with-potholes-heres-how-australia-can-avoid-them-188814">The road to new fuel efficiency rules is filled with potholes. Here's how Australia can avoid them</a>
</strong>
</em>
</p>
<hr>
<p>To ensure Australia meets its net-zero emissions target, we also need to seriously consider energy and fuel efficiency in transport. This could be by promoting the sales of smaller and lightweight vehicles, thereby optimising transport for energy efficiency.</p>
<p>In all of this, it will be essential for car manufacturers to take responsibility for their increasing contributions to climate change. From this perspective, they should move away from marketing profitable fossil-fueled SUVs that clog up our roads, and instead offer and promote lighter, smaller and electric vehicles.</p><img src="https://counter.theconversation.com/content/190743/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robin Smit is the founder and director at Transport Energy/Emission Research Pty Ltd (TER) and an Adjunct Associate Professor at University of Technology Sydney.</span></em></p><p class="fine-print"><em><span>Nic Surawski has worked on projects funded by city councils, alternative engine design companies, the Australian Coal Association Research Program, the federal Department of Environment and the Department of Climate Change and Energy Efficiency. Nic is a member of the Clean Air Society of Australia and New Zealand.</span></em></p>SUVs made up half of all new car sales last year. They’re a drag on Australia successfully reducing its total greenhouse gas emissions.Robin Smit, Adjunct Associate Professor, University of Technology SydneyNic Surawski, Senior Lecturer in Environmental Engineering, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1084292018-12-16T09:10:24Z2018-12-16T09:10:24ZUnpacking pain: what causes it and why it’s hard to measure<figure><img src="https://images.theconversation.com/files/249949/original/file-20181211-76971-17e3m1v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There’s a significant variation in pain sensitivity and tolerance.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Pain is difficult to measure. Unlike using a thermometer to measure body temperature, a blood test to measure blood glucose, or a magnetic resonance imaging (MRI) scan to detect a tumour, there are no instruments or tests that objectively measure pain. </p>
<p>To understand why, one needs to understand what pain is.</p>
<p><a href="https://www.iasp-pain.org/terminology?navItemNumber=576#Pain">Pain is a perception</a>, and like other perceptions (such as happiness, sadness, anxiousness), it reflects the sum of a lot of external and internal information interpreted by our brains. </p>
<p>For example, we have a specialised part of our nervous system that responds to harmful or potentially harmful stimuli, such as heat from a hot stove and chemicals from a stinging nettle. This system relays information on the location (like the tip of your right index finger) and intensity (the paper cut vs cutting your fingertip off) of a harmful stimulus to the brain. This sensory input is called nociception (detection of noxious stimuli). But the brain doesn’t only rely on incoming nociceptive information to generate our perception of pain. </p>
<p>Rather, the brain mixes the sensory information with lots of other sources of information. This other information includes the <a href="https://academic.oup.com/ptj/article/91/5/700/2735743">context in which you were exposed to a harmful stimulus, your emotional state, and your past experiences</a>. </p>
<p>In the context of all these variables, assessing the magnitude of someone’s pain is fraught. </p>
<h2>Some of the variable factors</h2>
<p>Context matters. For pain perception, context may reflect changes in a person’s:</p>
<ul>
<li><p>attention – a person feels less pain if they are distracted, </p></li>
<li><p>psychological state – a person experiences more pain when they are anxious compared to when they are calm, </p></li>
<li><p>cultural norms – in many cultures it is frowned upon for men to overtly express pain, </p></li>
<li><p>if a person is sleep deprived – lack of sleep increases pain sensitivity, and </p></li>
<li><p>if a person is a woman – women are more likely to have chronic pain conditions than are men. </p></li>
</ul>
<p>Past experience matters too. For example, if the last time a person felt a twinge in their lower back it developed into sciatica, with significant pain that took months of therapy to come right, the next time they experience a twinge in their back the person is likely to experience more anxiety and pain.<br>
Pain, you see, isn’t an input to the body, rather pain is an output of the brain’s threat detection system.</p>
<p>Another major factor is a person’s current state of mind. They may rate a noxious stimulus differently from day to day, or even within a day. Indeed, from your own experiences, you might appreciate that pain associated with an injury isn’t constant throughout the day. </p>
<p>There’s also significant variation in pain sensitivity and tolerance between people. </p>
<p>There may be large differences in contextual and experiential influences affecting how pain is perceived differently by people. Added to these influences, the pain experience is further complicated by inherent biological differences in the nociceptive and pain perception systems caused by natural genetic variation. </p>
<h2>So, how to measure?</h2>
<p>If pain perception is so complicated, how on earth is it reliably measured? Well, it’s actually quite simple: just ask the person. The <a href="http://downloads.hindawi.com/journals/prm/2002/971935.pdf">clinical adage</a>, “a person’s pain is what they say it is”, describes the approach perfectly.</p>
<p>Scientists and clinicians do, however, try to <a href="https://www.ncbi.nlm.nih.gov/books/NBK219245/">standardise</a> how people rate their pain using some simple scales. These can include scales that show various facial expressions associated with increasing pain, or asking people to rank pain from zero to 10. In all cases, scales are anchored at the extremes by the descriptors, “no pain”, and “the worst pain you can imagine/have ever experienced”. </p>
<p>But by translating a complex perception into a simple scale, important information can be lost, especially qualitative information about the nature of the sensation. For example, is the pain sharp, dull, aching, squeezing, shooting; or how the pain makes a person feel (worried, sad, anxious); and how it modulates behaviour (unable to do housework). </p>
<p>A simple scale of a complex perception also contributes to the high variability in ratings when ratings are repeated in the same individual, and biased ratings across individuals. </p>
<p>As scientists and clinicians working in the field of pain, we understand the limitations of our measurement tools, much like individuals who study diseases without objective diagnostic measures, such as depression and schizophrenia. We understand that the variability in our measurements is high and objectivity is low. </p>
<p>We have to work within these limitations to effect better pain management and to study the mechanisms of pain.</p><img src="https://counter.theconversation.com/content/108429/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Kamerman receives funding from the South African Medical Research Council and National Research Foundation.</span></em></p><p class="fine-print"><em><span>Antonia Wadley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How is pain measured? A person’s pain is what they say it is.Antonia Wadley, Lecturer in the School of Physiology, Faculty of Health Sciences, University of the WitwatersrandPeter Kamerman, Professor in the School of Physiology, Faculty of Health Sciences, University of the WitwatersrandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/291032014-08-01T04:34:16Z2014-08-01T04:34:16Z‘I feel your pain’: measuring the unmeasurable<figure><img src="https://images.theconversation.com/files/55384/original/sdftmhcn-1406783798.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pain-related behaviour is remarkably consistent between cultures.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-34482229/stock-photo-ouch.html?src=5Fidcv0lYQvdTYAoQO1Glg-1-143"> sybanto/Shutterstock</a></span></figcaption></figure><blockquote>
<p>There may be many pitfalls in an argument which equates sensation in humans with nervous discharges from frogs skin. – Edgar Adrian, 1932 Nobel Prize in Medicine</p>
</blockquote>
<p>Humans seem to experience pain, whether acute or persistent, in a unique way. As a species, we have evolved from having very simple damage-sensing mechanisms (which we share in many details with molluscs) to develop early warning systems that react not only to the threat of physical harm but to social and emotional harm. </p>
<p>As we added language and social behaviour to our capabilities, our experience of pain became more and more complex. The highest achievement of consciousness as a species is to develop <a href="http://people.howstuffworks.com/theory-of-mind1.htm">Theory of Mind</a>. This is the ability, through observation and imaginative empathy, to understand the interior experience of another organism. Having Theory of Mind is essential when attempting to quantify the pain experience of another.</p>
<p>Pain-related behaviour such as limping on a sore foot or shaking a hand which has just been injured is remarkably consistent between cultures. A Kalahari bushman could observe the behaviour of a suburban Australian and instinctively understand the severity and probably the location of the sort of pain they were in.</p>
<p>Melbourne neuroscientist <a href="http://www.med.monash.edu.au/psych/staff/profiles/giummarra.html">Dr Melita Giumarra</a> has been studying the phenomenon of <a href="http://www.anzca.edu.au/events/ANZCA%20annual%20scientific%20meetings/2013-anzca-annual-scientific-meeting/fpm-pdfs/fpm1-1-dr-melita-giummarra.pdf">“somatic contagion”</a>. Her work has shared fascinating new light on the relationship between our sense of embodiment, our empathy with others and our experience of pain. </p>
<p>Her initial research was prompted by the observation that many amputees who suffer from phantom limb pain will experience a worsening in their pain if they observe another person who appears to be in pain. She went on to examine whether pain can be socially contagious. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=893&fit=crop&dpr=1 600w, https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=893&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=893&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1122&fit=crop&dpr=1 754w, https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1122&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/55394/original/hn3shrrp-1406785508.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1122&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We can’t escape having to measure or quantify a pain.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/35mmmonkey/370318552">Renee Navarro/Flickr</a></span>
</figcaption>
</figure>
<p>Not only has she demonstrated that we can generally easily empathise with observed pain behaviour, but she has gone one step further to theorise that in some cases, pain can be experienced due to a top-down process of expectation. </p>
<p>In the lab, she has been able to produce the experience of embodiment of a fake hand with a wound on it by using the <a href="http://www.newscientist.com/article/dn16809-body-illusions-rubber-hand-illusion.html#.U88iBaiAT6w">“rubber hand illusion”</a>. Many subjects began to feel pain in their own hand (which was hidden from their sight) consistent with the injury on the fake hand.</p>
<p>While the issue of whether someone else’s pain is an <a href="https://theconversation.com/you-can-learn-a-lot-about-the-brain-by-working-with-zombies-14740">essentially unknowable experience</a> has been debated philosophically, there is at least some neuroscience which suggests there is a sound basis for saying sympathetically, “I feel your pain”.</p>
<p>Apart from simply observing behaviour, we rely on verbal descriptions and our own previous experience to add richness to our understanding of another person’s pain experience. In English, language related to pain generally has a negative connotation. This is likely because the word “pain” itself derives from the Latin word <em>poena</em> . This word also gave us “punishment” and “penalty”. </p>
<p>The diagnosis of <a href="http://en.wikipedia.org/wiki/Neuropathic_pain">neuropathic pain</a> depends heavily on a description of the pain “burning”, “tingling” or being “electrical”, as these words seem to be used consistently in every language so far studied to describe pain following a nerve injury. Many of the measurement tools in everyday use rely on verbal descriptions to differentiate pains that correspond to specific diagnoses. There is even current research linking <a href="http://www.ncbi.nlm.nih.gov/pubmed/23973136">verbal descriptions of pain</a> to the molecular mechanisms that cause it. </p>
<p>Non-humans can show placebo analgesic responses under similar circumstances to humans. Given they share so many of the basic neurological mechanisms with us, it’s hardly surprising they can also have these pathways activated by social or psychological conditioning. </p>
<p>Veterinarians or laboratory researchers have to base pain measurements in animals on observable behaviours such as vocalisations, tail flicking or withdrawal of a paw from pressure or heat sensations. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/55392/original/8b8jms8h-1406785186.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Vets monitor animal pain levels by observing their behaviour.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/chibirashka/2522767197/in/photostream/">naoko kawachi/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>Humans have a far greater emotional and cognitive capacity which adds layers to our placebo analgesic response. Pain researchers such as Edgar Adrian quoted above have long acknowledged the difficulty in translating basic mechanisms into lived experiences but we are getting closer all the time.</p>
<p>It’s worth noting that trying to separate the placebo, or context effect, of a treatment from the pharmacological or biomechanical effect is only really necessary in a research setting. </p>
<p>Simply put, the overall benefit minus the context effect is the treatment efficacy. We like to use treatments that “work” (have efficacy). We don’t like treatments that “don’t work” (don’t show efficacy superior to the context effect). This is one very good reason why pain measurement efforts are critically important.</p>
<p>Since pain is a multidimensional, private experience, it may seem futile to try to measure it. But it’s important to try. Since pain, in its everyday form, is a measure of injury, it can be a useful proxy for whether a condition is getting better or worse. Simple instructions such as “see your doctor if pain persists” rely on this relationship. </p>
<p>At a higher level, measuring pain as the “fifth vital sign” has become an important part of routine clinical practice in many hospitals. Attention to relief of acute pain improves both patient satisfaction and health outcomes. </p>
<p>Even in persistent pain situations, where patterns of daily pain are idiosyncratic and may be completely unrelated to any damage or injury, serial monitoring of simple pain measures can help with self–management strategies and with assessing responses to treatment attempts.</p>
<p>We can’t escape having to try to measure or quantify enough aspects of a person’s pain experience to be meaningful in the real world. </p><img src="https://counter.theconversation.com/content/29103/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Vagg does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There may be many pitfalls in an argument which equates sensation in humans with nervous discharges from frogs skin. – Edgar Adrian, 1932 Nobel Prize in Medicine Humans seem to experience pain, whether…Michael Vagg, Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist, Barwon HealthLicensed as Creative Commons – attribution, no derivatives.