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.