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Can You Rate Your Pain?

Using Pain Scales to Effectively Communicate Pain Intensity

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Updated May 21, 2014

Pain is subjective, which means no one but you knows how you really feel. This can make it difficult to determine whether or not medications or other pain treatments are effective. Nurses and doctors may ask you to measure your pain on a scale up to 10, or by pointing to a series of faces.

Types of pain scales

  • Numerical rating: Usually based on a scale from zero to 10, this scale assigns a measurable number to your pain level. Zero represents no pain at all while 10 represents the worst imaginable pain.
  • Wong-Baker: Represented by faces with expressions, this scale follows the same guideline as the numerical scale. Zero is represented by a smiley face, while 10 is represented as a distraught, crying face. This scale is useful when rating pain in children, or for adults with mild cognitive impairments.
  • Verbal rating scales: Using words to describe pain rather than a measurable scale makes verbal rating scales a qualitative measurement technique. In other words, the person in pain describes the intensity of pain, and how they feel. An example is the McGill Pain Questionnaire.
  • Observer scales: Often used with people who are unable to communicate their pain level effectively, observation-based scales offer objective measurements for pain. These include facial expression, muscle tone, blood pressure and heart rate. Some examples of observer pain scales are the FLACC scale, the CRIES scale and the COMFORT scale.

Related article: Which Pain Scale is Best?

The Purpose of Pain Scales

Most scales make pain measurable, and can tell providers whether your pain is mild, moderate or severe. They can also set baselines and trends for your pain, making it easier to find appropriate treatments. If your pain rating decreases after you take a certain medication, for example, then clearly that medication worked for you. If there was no change, or if the number increased, then your doctor knows it is time to try something else.

This is also true in the case of a verbal rating scale. Even though there is no numerical rating, doctors can look for a change in the intensity of pain words. You may initially describe your pain using more words from a high-intensity group. A treatment could be considered effective if in you choose more moderate pain descriptors afterward.

How to Use a Pain Scale

When a nurse asks you to rate your pain, try to be honest. Don’t exaggerate your pain. If you rate your pain as 10 out of 10, but are chatting happily on the phone with your spouse, you are probably not rating it accurately. This is also true if you rate your pain as a two, yet you feel like it might make you faint. The more accurately you describe your pain experience, the better your caregivers can help you control your pain.

Pain scales can also be an effective communication tool at home. Teach the scales to your family. Use a face scale to demonstrate the effects of your pain when talking to your children. Tell your spouse when you are a level eight, and show your children when you are at two tears. Using numbers and faces can help you communicate an otherwise subjective experience to the people you love.

Sources:

Pain Rating Scales: Overview. Pain Channel. Accessed March 10, 2009. http://www.painchannel.com/pain-scales/index.shtml

Pain Intensity Scales. NIH Pain Consortium. Accessed March 10, 2009. http://painconsortium.nih.gov/pain_scales/index.html

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