When I was in occupational therapy school, we learned to divide pain scales into two types: quantitative and qualitative. In other words, those you can use to measure pain, and those that describe pain, respectively. Both have advantages and disadvantages.
Quantitative Pain Scales – When You Need a Pain Number
Quantitative pain scales are assign a number or some kind of "marker" to your pain. Some examples include:
We often use quantitative scales (mostly the numerical pain rating scale) on our rehabilitation unit to determine whether or not a pain treatment was effective. For instance, our nurses ask patients to rate their pain before and after taking painkillers. Therapists use them before and after treatments, especially if we are using a pain modality such as TENS or ultrasound. If your pain number or marker stays the same (or if it increases) we know our treatment wasn’t so helpful. If it goes down, however, we know we found something that works.
Qualitative Pain Scales – When a Pain Number Isn’t Enough
Sometimes we're not looking for a pain number. We want to know how your pain feels, not how intense it is. Some examples include:
- McGill Pain Questionnaire
- The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)
These types of pain scales can help us define or classify your pain. For instance, pain that is described as sharp and stabbing may have a different cause than pain that is dull and throbbing.
As a therapist, I don't diagnose pain, but I often can tell patients what class of pain they may be experiencing based on their descriptions. For instance, if a person who has recently undergone neck surgery describes shooting pain from her shoulder down her arm, I can tell her it is likely nerve pain related to her surgery, or the condition that led to her surgery. If she describes a dull ache in her neck and shoulder muscles, however, I often assume it is related to muscle fatigue from her therapy exercises.
Hybrid Pain Scales – Combining a Pain Number With Description
Sometimes, a hybrid scale gives us the best of both worlds. Here are some examples:
- Memorial Pain Assessment Card
- Brief Pain Inventory
A hybrid scale not only gives us an idea of the type of pain you may have (and how it feels to you), but also how severe the pain is. This can be helpful both for diagnosing and treating pain.
Source:
Gould, Harry J III. “Understanding Pain: What it is, Why it Happens, and How It’s Managed” New York: American Academics of Neurology 2007
