Points noted. However, another thing that complicates this, is the “rule” in healthcare (and it’s a relatively new rule, all having to do with the newer trends in “patient centered” care ....Pain is whatever the patient says it is ....so, if they are saying they’re in pain (and maybe 1/10 is really faking it), you HAVE to treat them.
Pain and pain tolerance is rather subjective and as far as I know, there is no diagnostic test that can reliably confirm how much pain any patient is really feeling. Some people have a high tolerance for pain where as others have a much lower threshold. But a good experienced diagnostician however should be able to detect a faker.
For instance, when I went to the ER for my severe back pain the doctor asked a lot of questions and had me lay on my back and then lifted my legs and moved them in different positions to determine my pain level and whether or not I was faking it. He had me move in certain positions and asked me to rate my pain on a scale of 1 to 10. If I had been faking it and just seeking pain meds, I would have answered at least an 8 or more every single time but with a “slipped disc” some movements would be relatively painless while others would result in severe pain. The doc was able to determine that I wasn’t faking my pain based on my reactions. While a very good faker could fool some doctors, an experienced doctor is usually able to tell if someone is faking pain where there shouldn’t be any.