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.
Helpful Links
- Request an appointment
- Connect with others via the Chronic Pain group
The pick a number to rate your pain is not understood the same by everyone. When I first was injured, the medical facility asked me to rate my pain. I actually told them I did not understand the 1-10 number and how to rate my pain. I initially refused to answer this question as no one could really explain it. They were like 10 is the worst pain you've ever had and 1 was little to no pain at all. Well, that really did not help.
I don't recall what the "worst" pain I ever had. I just cannot remember what that may have felt like. Im sure there is reason for this???? Ok so it must be bad. I have gone to all the trouble and expense of going to see a medical professional for help. If I could have toughed it out, I would not be here, right. Hmmm ( 8 ), yea that sound good, (8) is my pain level.
Couple days later I am back on the job. Here comes the boss, are you ok, do you need to sit down or take a break. No, I tell him, I'm ok. He replies easy does it ok. I ask; What the hey is going on here. This is construction. We don't take it easy. He tells me he was contacted by HR and that I have a pain level of (8) and everyone is concerned. OMG, what did I do? Yes, it hurts and has been given me problems doing certain things lately, but now I am being diminished on the job. I am so embarrassed and all of a sudden concerned about keeping my job.
Back to the crux of the what's your Pain 1-10. After many visits to the doctor's office and many times trying to understand the 1 - 10 and many guesses at what my pain level was. I discovered the US dept of defense has a pain scale chart with emojis and a description under each. As a matter a fack there seems to be as many of interpretive pain (Happy to Sad) face charts are there are doctors. I chose the US Dept. of Defense pain chart because to me it was more descriptive and also offered a pain range. Took a picture of it with my phone and every time someone asks me now I look at this picture and pick one accordingly. I figure at least this way I am consistent. I'm not sure the medical personnel have any consistency or standard it which to interpret my numbers.
In short, the 1-10 is garbage as no one understands what it means.
I am lucky to have a physician experiencing extreme pain himself. So, we are both empathetic to each other's condition, even though my experience is caused by a different ailment. He has never asked me to rate my pain. He accepts the fact that it is severe.
Yes. I can relate. And I hope you find the things and people who will help you live better.
Venting is entirely acceptable in my world. I vent to my dog all the time. No harm done.
Hi meanderson,
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Until your dog gives you that OMG 😲 look then it's time to stop 😆
I’m amazed that natural childbirth is considered an 8 on the pain scale. Maybe mid-process is what’s being referred to?
Must be a dozen different pain scales. Everyone I have seen describes their interpretation differently. Being the pain sufferer, I have never been able to pick what I thought was the correct number. Also, the pain I am in changes by the hour. And then the sharp shooting pain on top of the pain that can last for 2 to 20 minutes. Does that get a separate number?
The number system left me feeling like I was in a land of make believe.
The Department of Defense has their own pain chart (of course). So, I took a picture of it and saved it on my cell phone. Now whenever I am asked my pain number. I show them my pain chart. (Everybody else has one why not me). This helps me feel like my number is more consistent.
No one really knows how to measure pain so guessing at numbers is what we do.
By the way the ankle pain that is kick your ______. That sort of pain barely bothers me at all. And well what's a little back ache. You want to know pain you should feel my shoulder pain! Thats sort of a joke. Some of us can tolerate more of one thing and that of another. Kind of like your burden is not as heavy to me and vice versa.
Making all the more difficult for me to understand pain and limitations associated with it.
The pain 0 to 10 when you are taking pain medications what do you use. With the meds I am at a 3 to 4, So when I am asked I always have to tell them that score is because of the medications. Too remind them that without them I would be at a 7 or 8. I have numerous issues, neuropathy, needing a knee replacement, torn rotator, and chronic neck pain. I am 70 years old, I would need surgery on every pain issue and I don’t want too do that, the meds keeps it low enough for a somewhat ok life. I do believe however if you have a doctor who simply believes all narcotic pain meds are bad get another doctor. I have MRIs on all ailments so they can see the issues. I take Gabapentin 300mg twice a day and 15 mg of MS Contin twice a day and Percocet for breakthrough pain.
I need to say define your numbers. All seem to interpret the scale differently. I go to the doctor when pain is intolerable. What number is that, I ask?