I am sick of 1-10 pain scale!

Mavericksmom

Maybe this was posted before, but I didn’t see it.

I’m so tired of being asked “On a scale of 1-10, how bad is your pain!” Yet, not once has any doctor at any time given me a list of what those numbers represent! There really is a medical term for each of those numbers, but who knows them? So we guess!

If we are just going to guess, why not do a scale of 0-4, no pain, slight pain, moderate pain, bad pain and excruciating pain?

I won’t answer that question with a number anymore. I now tell them how I feel and let them assign a number if they need to do that.

I know some places use smiley faces, which is okay, and probably necessary for some, but I would feel insulted if someone but a line up of smiley faces in front of me. That’s just me.

MelissaDallas

There is not. The whole point of the scale is that it is subjective to you. You are supposed to “guess” because the measure is your personalamount of distress. Not somebody elses.

Mavericksmom

There are charts, google pain scale 1-10

I am not trying to be difficult, but I find it VERY condescending for any doctor to ask pain on a scale of 1-10 and I won't answer in a number again! They can write down "patient refuses to give a number for pain" if it makes them feel better.

Tell me, how is a doctor supposed to know a personal amount? In science, and science is what my degree is in, numbers are quantitative measurements. Numbers should NEVER be used if the purpose isn't for a quantitative value.  

If it represented my personal amount, it really wouldn't mean anything as I don't remember what number I gave before, nor do I remember what I thought the number I gave meant.  It is a totally useless piece of information, that is better measured in words!  

gb2115

I hate the pain scale too. I have a chronic knee problem and I am tired of them asking me!!!

ksusan

Scaling by self report is quite common across disciplines. It's hard to anchor "pain," which has no objective measurement.

NancyHB

The scale is useful because because it allows for every unique individual to gage their own level of pain in a way doctors can recognize and assess. It’s a way to compare apples and oranges and get a measurable result.

Here’s an example: Melissa and I have the exact same surgery and our doctor wants to assess our pain the next day. I say “11.” My doctor can assume my pain is the worst I've ever experienced and I’m in a significant level of distress. Melissa replies “6”. Her pain may be less than mine, or her perception of her pain maybe
less, or her tolerance higher - whatever it is, the doctor has a frame of reference that says the pain is uncomfortable but not unmanageable, and can treat it as such. Our pain may be exactly the same, but our experiences and our tolerance are going to be completely different.

That number doesn’t have a definition outside of what it means to you. Your doctor hears “9” and knows your current pain management treatment isn’t working; a “3” might mean they’ve hit on the right pain meds, or you feel comfortable with your level of pain and don’t want/need meds. “0” after a bone fracture might indicate a serious problem where nerves are damaged. “10” after a sliver could indicate infection or unknown damage that needs to be investigated.

I appreciate the scale because it allows me to reflect on how I’m feeling and assess how much help I need from my doctor.

Mavericksmom

Hi Nancy. 

I know the medical community shares your view, they do like their 1-10 scale, but to me it is the most illogical logic I ever heard!  It is another example of medical math that doesn't add up!  No scientist in their right mind would ever rely on such a system! In science, numbers only represent quantity and every number includes a label, 5 cm, 150 lbs, etc. What label follows pain numbers?

It isn't a big deal really, not worth lengthy discussion, just something that annoys me.

I will NEVER give a doctor or nurse a number for pain. Numbers don't tell if a pain is dull or sharp, stabbing or crushing, chronic or acute. Numbers can only give a quantity. It would be like saying " on a scale of 1-10 that light shines like a 6!"  Really? 6 what?  

Maybe my views come from my years of working in research where such a scale would never be tolerated. Again, not really a big deal. 

MelissaDallas

If it is any consolation, the medical community hates the painscale and treating pain as a “fourth vital sign” too, and lays a lot of the blame for the opiate addiction epidemic at its feet.

gb2115

Well, I reported to my PT that my pain level was a 4-5 (which was true at it's worst, in the days after PT), once it settled down later in the week and I recovered it was more like a 2. But for insurance I could only pick one number. She told me to pick the highest it ever was during the week. Based on that, insurance rejected the request for more PT visits on the grounds that I was failing to improve because my pain was a 4-5. We had to appeal.

I didn't feel that picking one pain number was a fair assessment for insurance, who is removed from really understanding the case because they aren't there to base improvement on-- because in my situation it really depended on the day. I was improving but based on the way I answered they felt it appropriate to block further care to a person with an injury.

I get how in some circumstances it makes sense to use the scale, I just didn't appreciate insurance burning me like that. GRRR

Northerngirl485

The pain scale can be a useful tool to help people (I am a nurse). Being a tool it needs to be used correctly. When asking to rate pain from a scale of 1-10 number 1 being tolerable and you can still go on about your day to number 10 being mauled by a bear or worse possible pain. Also asking to describe the pain as in burning, ripping, burning, throbbing, etc is using in helping determine the origin of the pain (visceral verses muscular skeletal pain). The faces pain scale is not meant to be demeaning. I have also used it in adults couldn't place a number to their pain. The pain scale used with keen assessment skills can really help people when used properly. Seems like it may not being used properly by some health care professionals.

marijen

The opiod crisis burns me up! How good patients not abusing their drugs are treated like criminal drug users. Melissa, are the doctors aware of the lies of the opioid crisis? Now they have made the Guidelines more complicated. Not sure if this is a good thing or bad thing.

https://www.empr.com/home/news/cdc-clarifies-guide...

pupmom

But they give you smilie faces to help evaluate! When I was in chronic, unremitting pain for a year I always told them it was a 12.

Mavericksmom

Wow! I never knew that pain numbers were used for insurance reasons! Now I’m not just annoyed, I’m angry! I agree, you shouldn’t have been dropped!

From your comment maryjen, and Northerngirl’ comments, I am wondering if the whole pain scale thing came from the insurance companies and not the medical community. If that is the case, it explains why it is not scientific!

It really is true, you learn something new every day! Thanks for the comments! I guess I just lucked out with my random pain numbers that I gave my doctor because I never took them seriously! Yikes! I do think they need to have a chart for what each number represents. Maybe they do have one for breast cancer, but I never saw one.

It always amazes me at how much I learn from everyone here! I am so thankful for this community!

Mavericksmom

Northerngirl, can I ask, (because I want to know, I am not being sarcastic or rude) why 10? Wouldn’t 0-4 make more sense? 0= no pain 1- slight pain 2- moderate but tolerable, 3 severe, needing medication and 4 extreme pain that’s not tolerable even with medication?

Part of my annoyance with the 1-10 scale is I don’t know difference between 2-3-4 or 6-7-8 !

marijen

Here's the pain scale explanation. I always give them a number to document. Otherwise they will think I've got no pain when checking back.

https://www.prohealth.com/library/what-the-pain-sc...

Mavericksmom

OMG! What is the difference between Intense and utterly horrible? LOL, Intense sounds so much worse, could they choose worse descriptions? Utterly horrible? Who says that? A synonym of distress is extreme, and it is also a synonym for intense, so which is it?

Again note, 6 smiley faces, 5 labels on the number line, and 0 which would be no pain, again SIX! There really is no need for numbers 1,3,5,7,9!

To whoever makes these stupid charts, please be concise! Sheeeesh! Oh, sorry, I know they don’t go on BCO, and you are only the messenger! Maybe my OCD is kicking in! I think I need a “level of frustration” chart! 😂

Seriously, this is all quite interesting.....but I refuse to give my doctor/nurse a number. I refuse to play the “what number is your pain game!”There is nothing they can do about it anyway, because my pain comes and goes and It is in my breast, mid-section and lower abdomen due to mastectomy with DIEP reconstruction. I don’t need to take medication for it. I’m very thankful that I am not in constant pain and I feel so bad for those who are

marijen

My level of frustration is always a 10! 😅

Mavericksmom

LOL thanks for making me smile, marijen! I’m right there with you.....guess I don’t need a frustration chart! At least I wouldn’t be confused! 😐

Runrcrb

I watched my husband report “3” regardless of his pain level. He never wanted to cause trouble. He couldn’t stand up but would still answer “3”. When I started on this breast cancer thing, I googled the pain scale and in addition to the one above, I found a more descriptive scale of the 10 and I combined them, creating a 1-10 scale that I could use and be consistent when describing my pain.

leaf

I am NOT trying to belittle your pain. When I had at least a 9/10 pain on a mammogram-guided breast biopsy, and ended up from the psychological trauma, pulling out of the compressed mammogram machine on my next breast biopsy, I found this on the web. It points out some of the inadequacies of the pain scale in a humorous way.

http://hyperboleandahalf.blogspot.com/2010/02/boyf...

carmstr835

My problem is I cant remember. I can't compare. I know if I am in pain that it hurts and I don't like it, so I want something to help make it stop. If it isn't too bad, I can just handle it. That is my limit of assigning a number. I can recognize zero pain, slight pain, and bad pain, but other than that, I cant. My chemo brain makes it very difficult to make a comparison if I can't remember yesterday. I live for the moment. Luckily, I have little pain lately and have a high tolerance for pain, so rarely do I say bad pain.

marijen

Leaf, thanks for the laughs! In my case, it only hurts when I move.

Mavericksmom

ditto marijen, Thanks for the laughs! I loved those, copied them to show to friends! Humor really is a great medicine!😊

I realize I could do the pain scale with cat emojis!

😻 😼 😾 🙀😿

Thank you to all who posted here. Every comment was very much appreciated!

Northerngirl485

That’s a very good question! Ok the way I explain it is each new pain needs to be categorized. Let’s say we are talking about someone’s leg pain, I would ask to rate the pain based on past experiences with having leg pain in the past. I do this thinking most people at some point in their life has strained a muscle or bumped their leg to experience pain there.

There are many pain scales but the one most used is either the faces pain scale ( called the Wong baker pain scale) or the 1-10. So let’s say you have 10/10 pain and I medicate you. A while later I come back and ask you to rate your pain again and you rate it at a 5/10. This let’s me know the medication that I have given you has decreased your pain to 1/2 of what it was (obviously). So this shows the doc what he/she tried worked but needs improvement. There is no drug out there that will take pain 100% away, this is frustrating for both my clients and us health care workers.

The pain scale as you said 1-4 is too narrow of a range to treat pain. Of course we want your pain 100% gone and that’s our goal but we don’t generally hit that often. Over medicating to the point of being unconscious is when the client will not be in pain (of course this is said based on the type of pain as in trauma caused pain or cancer pain are much much much harder to treat verses a twisted ankle). Also life experiences with pain will cause people to over rate or under rate their pain. I personally have given birth and had pancreatitis and the pancreatitis was the worst pain I have ever experienced. Even the Whipples procedure I endured was nothing like the pancreatitis. So my wire guided biopsy/mammogram hardly hurt in my opinion but someone else it may have been the most horrific pain possible.

I hope I explained it and not confused the topic more. I like hearing the opinions as well as it helps me improve my assessment skills and my approaches to helping people with their pain.

60notpretty

Not only do I hate the pain scale of 1-10, I also hate the fatigue scale of 1-10. I may be very tired some days, but when I see my onc I may be feeling great. My appts are always early, so I do feel much better then than late in the evening.