Using the Pain Scale Effectively
by Karen Lee Richards, Chronic Pain Connection Expert
If you are a chronic pain patient, you have most likely been asked to “rate your pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine.” In fact, you’re probably asked to do that on a regular basis. The problem is, no one ever tells you what the numbers between 0 and 10 mean. We silently wonder what the doctor thinks they mean and try to pick a number that will adequately convey how much we’re hurting.
In an effort to remedy this situation, I’ve researched multiple interpretations of the pain scale and compiled what I think is the most commonly accepted evaluation of each number on the scale. You may be surprised by some of the descriptions. Please note: This guide is not official, nor is it approved by any medical associations. But hopefully it will help you rate your pain more accurately the next time you’re asked.
THE PAIN SCALE
0 – Pain free.
Mild Pain – Nagging, annoying, but doesn’t really interfere with daily living activities.
1 – Pain is very mild, barely noticeable. Most of the time you don’t think about it.
2 – Minor pain. Annoying and may have occasional stronger twinges.
3 – Pain is noticeable and distracting, however, you can get used to it and adapt.
Moderate Pain – Interferes significantly with daily living activities.
4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.
5 – Moderately strong pain. It can’t be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.
6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.
Severe Pain – Disabling; unable to perform daily living activities.
7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.
8 – Intense pain. Physical activity is severely limited. Conversing requires great effort.
9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.
10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain.
Using the Pain Scale If you want to be sure you and your doctor are speaking the same language, print out a copy of this pain scale and show or give it to your doctor so he knows exactly what you mean when you rate your pain.
Another common overstating mistake is smiling and conversing with the doctor, then stating that your pain level is a 10. If you are able to sit and carry on a normal conversation, your pain is not a 10… or even a 9. Actually, an 8 on the pain scale has been compared to natural childbirth. And as someone who gave birth to twins without an epidural or any medication, I can tell you that’s some pretty serious pain!
Please understand that I’m not trying to minimize the severity of your pain. On the contrary, I’m trying to help you learn how to have your pain taken more seriously. Pain is subjective and there’s no simple way to describe your pain to another person – even a doctor. The pain scale is certainly not ideal, but it’s all we have right now. I hope these guidelines make using it a little easier.
© 2009 Karen Lee Richards Updated 9/28/09