I am willing to bet that the people who are doing this criminal operation are going to tell me, “You are going to be tortured for a long time; do you want to be helped through it?” Or something similar. Um no! I wonder what really is happening?
When someone says they are being “tortured to death,” they are describing something real: the severity of what they feel and the threat they sense. But medicine draws a careful line between how much something hurts and how dangerous it is. Those two things often move together, but sometimes they don’t. Understanding the difference can help survivors, caregivers, and anyone trying to make sense of extreme suffering.
There is no reliable clock for how long a person can survive torture. A catastrophic injury can kill within minutes, while others endure severe abuse for days or longer. What determines survival is the specific physical damage, such as blood loss, organ injury, or dehydration, not the intensity of the experience.
Many people survive and live for decades, but rarely without lasting effects. Studies from torture rehabilitation centers report persistent pain in as many as 83% of survivors (Amanda C. de C. Williams and colleagues, Pain Reports, via PMC). Researchers studying US refugees found that this chronic pain is often misdiagnosed as only PTSD or depression, when it may stem from specific nerve and musculoskeletal injuries (PMC).
The Center for Victims of Torture lists long-term physical effects including headaches, musculoskeletal pain, hearing loss, vision problems, and neurological damage, along with psychological effects such as nightmares, insomnia, and memory loss (Center for Victims of Torture).
One point matters a great deal for survivors seeking to be believed: the 2022 revision of the UN’s Istanbul Protocol states that a lack of clinical evidence does not establish that a person was not tortured, or that their account lacks credibility (Physicians for Human Rights).
Clinicians most often use the Numeric Rating Scale, an 11-point scale where 0 means “no pain” and 10 means “worst imaginable pain” (PMC). A common interpretation, used by the Washington State Department of Social and Health Services, groups the numbers this way:
| Score | Meaning |
| 0 | No pain |
| 1–3 | Mild: nagging, interferes little with daily activities |
| 4–6 | Moderate: interferes significantly with daily activities |
| 7–10 | Severe: disabling, unable to perform daily activities |
The scale is self-reported, and no device can read another person’s pain. Even so, it is not guesswork. A systematic review by Marianne Jensen Hjermstad and colleagues (2011) concluded that numeric, verbal, and visual pain scales are all adequate for clinical use (Semantic Scholar), and a later review reached a similar conclusion (PubMed).
It also helps to know how pain is officially defined. In 2020, a task force led by Srinivasa Raja revised the International Association for the Study of Pain definition to: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (IASP; Jordan Miller, PMC commentary). In plain terms: pain is real even when no injury can be found.
Pain is a poor gauge of how close someone is to death, and that cuts both ways.
Some deadly emergencies hurt surprisingly little. The American Heart Association estimates that about 170,000 of the roughly 805,000 US heart attacks each year are “silent” (American Heart Association). Roughly 5–10% of aortic dissections, a tear in the body’s main artery, are painless (PMC case report).
At the same time, it is not quite accurate to say pain is harmless on its own. Pain or emotional distress can trigger a vasovagal reaction, a reflex that lowers heart rate and blood pressure and can cause fainting (StatPearls, NCBI). It is usually benign, but in rare severe cases it can progress to cardiac arrest (PMC case report). Intense stress can also cause takotsubo cardiomyopathy, or “broken heart syndrome,” which is triggered by emotional or physical stress in about 85% of cases and is usually reversible (Circulation).
The honest summary: severe pain and stress strain the body and can occasionally trigger emergencies, but the number on a pain scale does not predict death.
Psychological Torture Is Torture
Torture does not require physical wounds. In a 2020 report, UN Special Rapporteur on Torture Nils Melzer described psychological torture as methods designed to inflict severe mental pain or suffering “without using the conduit or effect of severe physical pain or suffering” (Doughty Street Chambers).
Sleep deprivation is one of the clearest examples. Writing in the AMA Journal of Ethics, the authors argue that deliberate sleep deprivation is still used as torture and that poor sleep is linked to cardiovascular disease and impaired attention (AMA Journal of Ethics). Research published in the Torture Journal found that detainees exposed to prolonged sleep deprivation reported greater acute and chronic suffering, with lasting family, social, and physical effects (Torture Journal).
If you or someone you know feels they are being tortured, physically or psychologically, a medical evaluation matters. It can find hidden dangers like the silent emergencies above, document injuries, and treat pain even when its cause is unclear.
- Emergency: Call 911 for chest pain, fainting, sudden weakness, or if someone is being harmed right now.
- Emotional distress or feeling unsafe: Call, text, or chat 988, the free, confidential, 24/7 988 Suicide & Crisis Lifeline.
- Torture survivors: The Center for Victims of Torture offers medical, mental health, and social services.
Suffering deserves to be taken seriously, whether or not it leaves a mark. And pain, however overwhelming, is a signal to get help, not a countdown.