The pain scale

Every physician, nurse, physical therapist, and any other medical provider is familiar with the pain scale. This means every client is too. You know, “how high is your pain on a scale of 0-10”. This scale is valuable and necessary, but frustrating to all involved. We just want you to give a single number answer that gives us a vague idea of how you are doing right now or what your worst pain is to understand how much is limits you. You want to say “I don’t know” (because how do you number your pain), you want to answer a range (3-5/10), you want to say 11, you want to give half scores, or you want to say your pain is not on the scale because it is just discomfort.

Let me explain the brilliance and annoyance of the pain scale.

We are not looking for this to be an exact measure

Pain is a vague thing, so it is hard to put a number on it, but you can. The pain scale is unique to you. It gives us a snapshot in time of how you are feeling your pain. It tells us whether you have definitely improved, definitely gotten worse, or somewhere in the middle. We are not looking for you to compare to your previous responses or for perfectly accurate descriptions. Just give your best assessment of how your pain feels right now.

The range does not exist

As I said, the pain scale is meant to be a snapshot in time. What number is it at its very worst. It cannot be 6-8 at it’s worst, since 6 is not as bad as 8 then 8 is the worst. It cannot be 3-5 currently because we are asking about this very moment, it is not changing that quickly.

The scale stops at 10

If you walk into my office smiling you are not currently at a 10/10 pain. 10/10 means you are moaning on the floor while I call 911. 10 is a bullet wound. 10 is a stab wound. 10 is what you feel at the emergency room. If you have not begged someone to call 911 or been at the emergency room then 10/10 is not your highest pain or your current pain. And, you cannot be an 11 if 10 is the worst pain you can imagine.

Half scores are allowed by some of us

If it helps someone answer, then I am willing to take half numbers, but not all providers will. We are not looking for precision, just to get an idea of your pain.

Last, but not least: your discomfort is pain

If you think you just have discomfort, but not pain, then this last part is especially for you! The whole point of the scale is to be able to assess the full range of discomfort to pain. Pain is usually used to describe higher levels of pain, and discomfort is for lower levels of pain. See how I just told you that discomfort is pain? If your discomfort is noticeable, then it belongs on the scale. If your discomfort was more intense, then you would call it pain, right? Then it is just low level pain. That is why we have 0, 1, and 2 on the scale. These numbers perfectly describe low level discomfort that is annoying. If it is pain when intense and high level, then it is pain when only a little uncomfortable too.

Trust me, if you just answer and move on, you will actually improve the accuracy of this assessment and it will be less painful for everyone involved.