Can we ever truly measure pain?

There's a fascinating debate happening among pain researchers right now: will we ever be able to measure pain objectively, the way we measure blood pressure or temperature?

Is this important, in my opinion, YES. Because we currently have no objective way to measure pain, people with very real pain can sometimes be told it's "all in their head." Anyone who's experienced that will know how invalidating it feels.

Here's part of the problem. Scans like MRI, CT and X-ray are excellent at spotting serious injury and certain diseases, and that's exactly what they're for. But once anything serious is ruled out, the findings on a scan often don't match a person's pain. Things like disc bulges and age-related "wear and tear" show up just as often in people with no pain at all. A scary-sounding scan report doesn't necessarily explain your pain, and a clear scan doesn't mean your pain isn't real.

Recently, researchers have started making real progress measuring the nervous system's "danger signalling," known technically as nociception. These are the electrical signals that fire when the body detects a threat of tissue damage (or actual damage). It's exciting work, and it could genuinely open doors to better treatments down the track.

But here's my take: this will never replace the only measure of pain that truly counts, which is your own experience of it. There are two reasons.

First, nociception and pain aren't the same thing. They're related, but the exact relationship still isn't fully understood, so measuring nociception wouldn't necessarily tell us what someone is actually experiencing.

Second, and most importantly, a number could never capture the thing that matters most: how much your pain actually affects your life. Two people can report identical pain levels on a 0-10 scale while one carries on largely unaffected and the other finds daily life a struggle. That difference, the way pain interferes with what matters to you, is the part no scanner will ever read off a screen. It's also exactly what we care about most in the clinic.

If you'd like to explore the more sophisticated version of this debate, a group of pain experts made this case in a recent Nature Neuroscience opinion piece, "Why pain biomarkers cannot replace the patient experience" (https://www.nature.com/articles/s41593-026-02324-x)

And if you disagree with any of this, please tell us. We genuinely enjoy hearing how others think about it.

Written by

Samuel Bulten

Exercise Physiologist | Masters in Medicine (Pain Management)

Director, Adapt Movement

Disclaimer

This information is for educational purposes only and is not a substitute for personal medical advice. These blogs are written by Sam Bulten and represent his opinions and insights and are based on his experience and interpretation of the research. As Sam is a human, these opinions and insights are not absolute truths.