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Pain Scales: Quantifying the Subjective

Whenever a health care provider asks my pain level on a scale of 1-10, I start with a disclaimer. Pain levels are entirely subjective and it is nearly impossible to assign numbers to vague concepts that vary from one person to another. This comparative pain scale is one of the best I’ve found, but my level 3 is a 6 on this scale

Putting numbers into words makes an ill-defined, fuzzy scale into perspective. Detailing what the numbers mean to you may help you track your pain more consistently. Some people recommend sharing the detailed chart with your doctor. Not a bad idea, except few doctors have the time to sort through all that. And he or she can’t keep track of what your scale means compared to Jenny’s or Lucy’s or Dave’s. It may be too much information to expect them to digest.

Instead of trying to assign numbers, researchers usually use a simple scale of none, moderate and severe. I use a more detailed version with mild, mild-moderate, moderate, moderate-severe, and severe. I still refer to numbers sometime, but they are always within the context of this classification. For example, 6 is moderate, 7 is moderate-severe.

What’s your pain scale? How have you communicated it to your health care providers?

8 Responses to Pain Scales: Quantifying the Subjective

  1. Megan says:

    I have trouble even determining if my today’s 3 is a yesterday’s 2 or 4, if you see what I mean, let alone how it compares to the doctor’s scale. I like your descriptive terms; they seem more useful to me.

  2. Kelly McEnaney says:

    When my daily headache hell started, I created a pain scale in my attempt to give friends and family a reference that they could understand. I started with what it feels like to smack your head against the side of a car when you’re trying to get in the back seat. Lots of people have had that experience, particularly if they or their parents ever owned a two door car. So, smacking your head against a car door is pain level one – that is my base level. I haven’t had a day without at least that much pain in years. From there it goes to level two, what it would feel like if someone slammed your head in a car door. Not as many people have experienced it, but most can imagine it. Then we move to getting your head run over by the car at level three, still a manageable day, but I’m not as nice a person. Then my head is run over by a mack truck at level four. I can still handle minor life activities, probably will shower and manage at least one meal that isn’t cereal. Finally, at level five, I ask the truck to back up again to kill me. I’m not functioning, I can barely get to the bathroom and need help to feed my dogs.

    I’ve since used the scale with my doctors and I even used it when I was hospitalized at a headache clinic for a month. We were supposed to write down our pain number every day. After a while, I started drawing pictures based on my pain scale. I like my scale because it helps me keep my sense of humor about what we face on a daily basis.

  3. ChristinaP says:

    I hate numeric pain scales, and find them more or less meaningless. Your “7” could be my “6” and someone else’s “9”. I have no idea why my colleague’s cling to the concept.

    Pictures are fine on a one-to-one basis but, of course, are not suitable for quantification such as is needed for research.

  4. Anne says:

    I have basilar migraine and therefore *hate* the pain scale. I feel like I am dying. My head is buzzing. I am doing back flips. I am hearing music that is not there. I have no concept of where my body is in space. I’m confused and disoriented. I’m sobbing.

    But pain scale? I’m not sure? What is a number? No, I can’t see the chart on the wall that is spinning. You want to know what part of my head hurts? I don’t know. Do I have a head?

    I often say 8 if I am at that point where nothing makes sense. I like the Comparative Pain Scale.

  5. MaxJerz says:

    I keep two scales, one for pain and one for disability. Both are 0-10 numeric scales. I’ve found this to be more useful than just keeping a pain scale, since some days my head doesn’t hurt that much, but other symptoms (dizziness, nausea, photophobia, etc) are so awful that my disability level is high. Or vice versa. This also helps the emotional component of actually coping with constant pain to have a place in the rating scales. It’s not perfect, but it’s the best solution for me I’ve found for now.

    Be well,
    MJ

  6. Katherine says:

    I overthink whenever I’m asked what number. I don’t want them to think I’m overreacting, but I don’t want them to think that I’m not in any pain. So I usually end up giving myself probably a lower number than I should.

    Plus it depends on the day, what was a 3 yesterday when I was in a good mood, and it was sunny and I was productive, could become a 5 today when I’ve been broken down by the pain, it’s raining and I’ve gotten nothing accomplished. So not only do pain scales vary from person to person, they vary day to day with the same person.

  7. Nicole says:

    I’ve often wondered if such a thing as this existed! Now I know it does. I have even asked women who have given birth if that is more painful than a migraine. One woman told me she would much rather give birth! Pain is so subjective. I think my migraines range from 4 to the very occasional dreaded 8. I also think pain that you’re used to is easier to bear than “new” pain. I notice people having their first headache find it unbearable and very frightening. Meanwhile I’m afraid of getting my upper ear pierced. How silly.

  8. Jesso says:

    Amazing to see people who do actually experience pain and despise the pain scale as it is too subjective. I have experienced pain so severe that I was momentarily blinded and could not see anything other than white, completely incapacitated and still standing. This is my scale of 10, another whose only experience with pain is a sunburn would put their pain scale at 10, where as I would only see 1. Hope this helps when the medical team asks you how does it feel on a scale of from 1 to 10

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