Rating Pain on a Scale of 1 – 10

The standard for measuring pain is a scale of 0 to 10. Zero means having no pain. Ten means having the worst pain imaginable. Many physicians require their patients, each time the patient is seen, to rate their pain; therefore, it is most important to be able to accurately assess one’s pain and reliably report it to the doctor in a reasonably consistent manner.

Although tempting, one of the worst things which a patient can do when asked to rate his or her pain is to give a rating above 10. Such a rating indicates to the physician a lack of respect for the scale. It tends to negate any other answer given by the patient because it represents an exaggeration. You should think very carefully before giving a pain rating of 10, especially if able to drive to the doctor’s office and, even more importantly, walk into the doctor’s office under your own power. Every one of us can imagine pain so bad that we cannot walk or drive. Of course, so can the physician. Therefore, if you are experiencing the worst pain you’ve ever felt, but can imagine worse, simply say so.

While the pain scale outlined hereinbelow is fairly standard, it sometimes helps to define what each of the numbers means to you, so that your doctor knows just how you are defining each level of pain. This is especially important if your physician asks you, on a regular basis, to rate your pain. With the foregoing in mind, the following represents a fairly standard pain rating on a scale of 1 to 10:

ZERO: No pain

ONE: Pain which is so slight that you must focus on it even to be aware that it is there. It is similar to, perhaps, a slight sunburn.

TWO: Pain which makes you uncomfortable; but it does not interfere with normal activities, either physical or mental. It is not bothersome enough to need to use an aspirin.

THREE: You are aware of the pain at this level most of the time; however, diverting attention from the pain with significant activity can mask the pain. The pain can be blocked, in this way, without the need for medication. By evening, however, the pain, which might have been a level three all day, may turn into a level four, simply due to fatigue or the lack of interesting activity to block the pain.

FOUR: This intensity of pain would normally call for a sufferer to reach for an over-the-counter pain reliever, like aspirin, Tylenol, Excedrin. At this level, everyday functions are affected, although not yet limited. If you could keep your pain at this level, you could live a normal life, work with a few limitations, and have only minor limitations on your recreation and social activities.

FIVE: Everyday activities become difficult. Concentration is difficult and physical activities are more limited. You simply can’t help being irritable. The pain, while bearable, perhaps with the use of a TENS unit, prescription anti-inflammatories, or narcotics, does not allow you to live a normal life. Although you can still hold a job, the pain leaves you with little or no energy for anything else but work and resting from work.

Enjoyment of social activities is gone, as is the enjoyment of simple family occasions.

While sleep is difficult, when it does come it can still provide some measure of relief. Upon awakening, you can feel somewhat rested and feeling better than when you went to bed.

SIX: Your pain begins to be described as being “unbearable.” Over-the-counter medications, no matter how many or what variety are taken, don’t touch the pain. Most with a level six pain have given up on Ibuprofen, aspirin, and Tylenol, recognizing that they do not provide any noticeable relief.

The level of pain intrudes upon the simplest of tasks, making everything difficult. At this pain level, you can no longer enjoy reading a book or watching a movie. You might read the same paragraph six times over with no understanding of what it says. The scenes in a movie have no relationship to each other. While you can still carry on a conversation, it needs to be short and simple.

At a level six pain, holding a job which requires any attention whatsoever is not feasible. Concentration and attention to detail is missing. You cannot sit or stand for more than half an hour without the pain shooting up to a level six.

At level six, sleep may still provide occasional relief or escape. More often, though, your sleep pattern has been altered enough so that you end up being unable to sleep at night if you sleep during the day.

SEVEN: You deal with pain constantly. Sleep brings no rest, if it comes at all. Dreams consist of pain, with useless attempts to escape. It is difficult to focus on anything but your pain. Reading is quite impossible. Not only do the sentences not connect with one another, but the words don’t go together, either. Memory is impaired and you end up having to write down anything which seems to be important enough to be remembered, like birthdays, anniversaries, and appointments.

With no distractions whatsoever, you can sometimes focus, on a short-term basis, enough to block the pain from getting worse, although it does not decrease the pain by itself.

EIGHT: Pain level eight leaves you usually housebound. All your energy goes into enduring the pain, even to the point of some- times forgetting to breathe. Blocking the pain, however, is impossible. Sleep seldom comes when the pain is at this level. When it does come, it is brief, fitful, and provides no restoration or relief.

NINE: Your pain is no longer localized. The pain seems to have invaded every part of your body. Getting out of bed is almost impossible; but, sleep itself is no longer possible.

TEN: At level ten, you simply can’t move – it’s too much effort. You are so consumed by the pain that nothing else seems to exist.

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