🧠 Can AI Predict Your Pain?

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In today’s Sunday Special:

Read Time: 7 minutes

📜THE PRELUDE

Your stomach tightens as you curl into yourself: chest freezing, arms flexing, and knees folding. The pain won’t settle. It swells, strikes, and spreads. The sterile hospital air bites at your nose. The side rails of the medical bed press into your palms like a brace, anchoring your hands against the tremor of pain.

Beside you, a nurse inquires: “On a scale of 0 to 10, with 10 being the worst pain imaginable, how do you feel right now?” This isn’t the worst pain imaginable. You can imagine worse. You’ve felt worse. Your throat tightens: “About a 6.”

The nurse nods and records the response, briefly examining your body temperature, blood pressure, and breathing rate, all of which are within the normal range. Despite this, your pain seems more intense than a typical “6.”

The nurse seems to wonder whether you’re downplaying it. At this moment, there’s no way to tell because everyone feels pain differently. Yet, your pain rating is essential for recovery, serving as a key indicator to guide the prescription of powerful painkillers.

Pain is one of medicine’s most important symptoms, yet it remains stubbornly subjective. Nearly every medical appointment you go to these days will ask if you’re experiencing pain. If you say, “Yes!” the next question will likely be, “Please rate your pain on a scale of 0 to 10.” So, what if pain could be anticipated and addressed before you ever feel it?

🦴THE FUNDAMENTALS OF PAIN

Pain is one of the most universal human experiences. Everyone feels pain, whether from stubbing a toe or being stung by a jellyfish. That shared feeling is what allows us to wince in sympathy when our best friend breaks their leg falling from a ladder. You can imagine how awful their pain must feel, even if you’ve never experienced that exact pain yourself.

Although you may be able to imagine it, there’s absolutely no way of knowing exactly how your best friend feels. We’re entirely alone in our pain because it’s beyond our ability to know whether the pain we feel is identical to anyone else’s. More importantly, pain isn’t visible. We mainly rely on seeing signs of pain through wincing and grimacing, meaning the true intensity of someone’s suffering can be difficult to detect.

The IASP defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” Crucially, the IASP clarifies that pain is always a personal experience shaped by biology, psychology, and sociology.

The NPRS is an 11-point scale ranging from 0 (i.e., “no pain”) to 10 (i.e., “the worst pain imaginable”). Its simplicity and efficiency have established it as the most commonly used instrument for pain assessment. Still, by reducing pain to a single numeric score, it fails to capture the full scope of an inherently complex, personal experience.

In 1991, American clinical psychologist Dr. Charles S. Cleeland addressed this flaw by developing the BPI: a self-administered questionnaire that assesses pain severity and how it interferes with everyday function. It asks about the location, intensity, improvement, and impact of pain. Although the BPI is far more comprehensive, it still relies on a patient’s ability and willingness to describe their pain.

💊THE DANGERS OF OVERTREATING PAIN

In 1995, pain specialist Dr. James N. Campbell urged the APS to elevate pain to the status of “the 5th vital sign,” meaning it should be routinely measured and monitored in every patient.

In 2001, the U.S.-based body that accredits hospitals worldwide formalized this recommendation, encouraging healthcare organizations to assess pain in every patient encounter. As a result, pain ratings became routine alongside the four primary vital signs, which are always checked to monitor basic body functions. This decision tied pain control directly to a key success metric: patient satisfaction.

From 1995 to 2015, prescription opioids like oxycodone and hydrocodone nearly doubled in the U.S., with approximately 568,699 Americans dying from opioid overdoses. By 2016, the AMA decided to remove pain as “the 5th vital sign,” acknowledging the pivotal role it played in exacerbating the opioid epidemic.

🧬AI AND SICKLE CELL DISEASE

Affecting over 8 million people worldwide, SCD is an inherited blood disorder that causes your Red Blood Cells (RBCs) to form into a “C” shape and clump together, preventing oxygen from reaching vital tissues and damaging organs.

When people with this inherited blood disorder get sick, stressed, or fatigued, they risk a VOC: a sudden episode of severe pain caused by blocked blood flow to multiple organs, affecting the ability to breathe. This event contributes to about 95% of SCD hospitalizations.

In a pediatric hematology clinic, a hematologist opens a patient dashboard for a 17-year-old male with the inherited blood disorder. It was created by Sanius Health, which developed an AI-powered pain prediction algorithm to detect the onset of a VOC. So, what makes this possible?

🔑KEY TAKEAWAY

Pain is hard to measure by nature because it’s personal. While AI can’t fully capture the subjective experience of pain, it can make pain management less reactive and more proactive.

📒FINAL NOTE

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