Assessing Levels of Chronic Pain
Created | Updated Apr 3, 2003
In order to facilitate better communications with patients recovering from surgery, hospitals use a pain scale to assess the need for medication. This same scale can also be used by the patient suffering from chronic pain to assist the physician or therapist in prescribing the correct path of treatment.
Adult pain scales are rated on a range from one to ten; with one being no pain and ten being worst then any pain, you could possibly contemplate. Children use a similar scale featuring faces getting progressively sadder; again ranging from happy equal to no pain and tears equal to the worst then any pain they thought possible (please note: even though this scale can be used for children as young as three, this scale is generally only reliable in children over the age of 4-1/2). However, anyone who has experienced pain can relate to the face chart by simply looking in a mirror.
Pain is subjective. Depending on your threshold level, what one person may rate at a five might get a two rating from someone else. When discussing pain level with your physician or therapist, it is helpful to create a chart based on the one to ten scale and giving examples of what that level means to you.
A sample chart created by an RSD patient is included below. By only listing the even numbers, she has allowed room for various degrees within the descriptions.
RATE | DESCRIPTION | ALLOCATION |
|---|---|---|
10
| Totally Disabling STOP NO MORE | Extreme burning and stabbing sensation (red-hot knives being twisted and poked through ankle/foot) Happenings during triggers including change in weather, over-exertion, and flare up of PTSD Can happen for no sane reason I can determine Try to remember to breathe Usually brief in duration (1–3 minutes) but reoccurring Give up and pop a painkiller Hope to pass out quickly Just shoot me, please! |
8
| Severe Total lack of concentration Sometimes able to do basic tasks | Fugue Yelp, cry , swear, flinch Moderate duration (several minutes to hours, depending on my resistant to taking meds) Currently about 20% of my day |
6
| Distressful Partial lack of concentration Able to do familiar tasks | My normal state Burning and cramping sensations Can be relieved with meds, which I do not want to rely on |
4
| Tolerable Can be ignored somewhat | Burning and stabbing sensations. Usually when I am asleep, but it is starting to wake me up again. |
2
| Mild Aware of pain but able for the most part to ignore it | Rarely. Only if I manage to totally immerse myself in an activity or my adrenaline level skyrockets. |
0
| Pain Free | Once in the past 6 months |
Threshold levels and tolerance to pain change. With chronic pain, the patient’s tolerance to pain increases over time while the threshold goes down. The patient perceives the pain sooner but can endure it longer before escalating to a higher level. Therefore, to accurately communicate, periodically you need to re-evaluate and revise your chart.
