The Dreaded Pain Scale
Nearly every medical appointment you go to these days will ask if you are experience pain. If you say "yes" the next question is likely "please rate your pain on a 0 to 10 scale." This can be confusing to you as a patient and you might be wondering, "how do I put a number on my pain?" "What is my provider really asking?"
There are several types of pain questionnaires that clinics use which are slightly different in content, the number of questions and the actual scale used. We have developed some Frequently Asked Questions (FAQs) to help makes this a meaningful part of your next visit.
Why is rating your pain so important?
The purpose of the pain scale is to provide a standardized means of measuring pain intensity and severity. Everyone experiences pain differently and each of us has a difference tolerance for pain. Therefore, your pain score is unique to you. You might provide an explanation for your pain score. For example, "on my best day my pain is a 0, but at its worst it is a 6."The goal of asking a number is to identify how pain is affecting your routine daily activities. By giving the numbers some definition, we hope to help you assign a number.
- Pain Free = 0
- Mild Pain = 1-3 (nagging or annoying but doesn't interfere with daily activities)
- Ranges from "barely noticeable" to "distracting" because you are somewhat used to it and have learned to live with it
- Moderate Pain = 4-6 (interferes with daily activities)
- Ranges from "distracting pain that can only be ignored for periods of time" to "difficulty concentrating"
- Sever Pain = 7-10 (disabling or unable to carry out normal daily activities)
- Ranges from "impacts your social relationships, or sleep" to "being bedridden or even delirious."
What shouldn't I do when talking about my pain?
Do not overstate your pain. While you want to convey that your pain is severe, saying your pain is a 12 out of 10 while sitting upright in the doctor's office may not be to your benefit. Consider that natural childbirth (no epidural or medication) is generally thought to be an 8 which means that your physical activity is severely limited and talking requires effort.
How can I make the score mean more?
Give your pain more than just a number. Being able to describe your pain will help your care team better understand how it may be impacting your daily activities. Consider the following:
- Does the pain come and go or is it always present?
- What makes it better?
- What makes it worse?
- What word best matches how it feels? Stinging, penetrating, dull, throbbing, achy, nagging, gnawing...
- Does the pain stay in one spot or does it travel to different parts of your body?
Just as important as pain scores is your functional status in response to the treatments or interventions you have already tried.
- Have you been able to walk farther?
- Is the pain less which allows you to do more for yourself (i.e. get dressed, go to the bathroom independently, brush your hair)
- Can you sit upright and working on your knitting (or other meaningful hobby)?
- Are you able to go to your local worship service (or other meaningful activity)?
What is the difference between acute vs chronic pain?
In general, healthcare providers divide pain into two categories - acute and chronic
Acute Pain: acute pain is temporary, related to the physical sensation of tissue damage. It can last a few seconds to a couple months, but generally subsides after normal healing occurs
Chronic Pain: Chronic pain lingers long beyond the time of normal healing, lasting from a few months to many years. It may range from mild to disabling and change frequently.
You may already have chronic pain and are now experiencing, acute pain. Your care team will ask you specific questions to help determine whether this pain is new (acute) or whether it is related to your chronic pain. Understanding how to use the pain scale and communicate your pain to your care team will help determine the best treatment options for you.
Thank you for posting this. Love that you gave a description for the levels of pain. Since I was little pain to me was if I cried it was pain and if I didn’t cry it was just discomfort. I have always found it difficult to give my “pain” a number. I will find this very useful. Thank you!
Thank you! A few of my doctors' nurses always ask about my pain level … I want to be accurate; I have wondered what the numbers convey to them. Peggy
I thank you for this too. It really helps put pain in perspective. In all the years I have been going to rheumatologists and or pain clinic no ever gave me something so clear. I appreciate you sharing
This is a pic of my X-ray. I have broken Harrington rods in my back from a car wreck when I was 17. I am now 58. I’ve literally lived with some level of pain since the second we hit the tree going about 20-30 miles per hour.
My pain levels never get below a 6-7. Thanks in advance for creating this place for giving me a place I can at least know I’m not the only person in paim
Have you seen a back specialist recently? Since you were so young when you had them implanted, would your body have healed enough that you don't need them? I hope this isn't a stupid question but at 17 you were still forming good bone. I was in pain everyday from osteoarthritis and I started taking dehydrolized collagen (Land of Lakes) every day with coffee or fruit juice and I am feeling 95% better…I urge everyone to look into this supplement…it helps with virtual every organ, muscles of our body because our body is made from collagen and we start making less in our 20's…supplementing with this has made a huge difference in my quality of life!
Oh honey please no question is stupid. I’v learned ( because I did it for you) NOT asking is stupid lol. The problem is no one wants to touch me because of the nerves and scar tissue being grown around the rods. 😞
They said scar tissue is hard as stone. They basically have to saw thru it. So if they were to slip it’s uh oh for me.
The brain and spine is apparently very touchy areas for nerves.
I will absolutely check on collagen therapy. Heck what do I have to lose. !? I’ll take 95% for sure! 👍🏼
I surely do appreciate you taking the time to tell me about it and replying.
Thank you have a marvelous Sunday.
I am a young 81-year-old woman who had both knees replaced two months ago July 29, 2019 I’m having some problems with IT band syndrome any information you can send to me would be appreciated extra exercises and whatever
Look into having a pain pump inserted. Tiny doses of medication in the right place can work wonders.
Hi @1prettymess, I think you might be interested in following the Spine Health group https://connect.mayoclinic.org/group/spine-health/
Here's at least one specific discussions that you may wish to explore or post to. There are many others.
– Harrington Rod and lower back pain https://connect.mayoclinic.org/discussion/harrington-rod-and-lower-back-pain/
Hi @meanderson, I recommend that you follow the Joint Replacements group https://connect.mayoclinic.org/group/joint-replacements/
There you will find an active group of people talking about total knee replacement therapy, post surgery and IT band issues. Here are a few discussions that may interest you. I encourage you to explore the group.
– Having knee replacement: how to prepare and questions about PT https://connect.mayoclinic.org/discussion/im-having-knee-replacement-l-on-june-20th-any-suggestions-on-how/
– IT band syndrome after knee replacement https://connect.mayoclinic.org/discussion/it-band-syndrome-after-knee-replacement/
– IT Band https://connect.mayoclinic.org/discussion/it-band/