The Pain Score and Measuring Pain
Pain is a subjective complaint. It
cannot be seen, touched, or measured. We depend solely on the patient’s
account of the pain in order to keep track of it. Since everybody tolerates different
degrees of pain, the best basis of comparison is the patient itself. To achieve
this, we use a pain scale called NAS-11 (Numeric Analog Scale
from 0 to 10 [11 characters]), where “0 = No Pain”, and
“10 = the worst possible pain that you can even imagine” (i.e.
something like been eaten alive by a shark). You will be asked to rate your
pain on every visit, as well as multiple times before and after a procedure.
Please be as accurate as possible, remember that medical decisions will be
based on your responses. Please do not try to overemphasize your pain by giving
us a number above the upper limits of the scale (i.e. “15”).
This will actually be interpreted as “symptom
magnification” (exaggeration), as well
as lack of understanding with regards to the scale. To put this into
perspective, when you tell us that your pain is at a 10 (ten), you are
essentially saying that you are at a level of pain where there is nothing
else that anybody can do to inflict any more pain on you. (Carefully
think about that.)
Rating pain
When you use a system to rate your pain, you help your
health care team do a better job of assessing it as they begin treatment. More
importantly, using the same rating system over time helps them to understand
how effective the treatment is at relieving your pain and to adjust the
treatment for maximum benefit. Some people find it easiest to use a simple
range of words to describe their pain: no pain, a little pain, lots of pain,
too much pain. Other ways of rating pain include:
The Wong-Baker Faces Pain Rating Scale
Designed for children aged 3 years and older,
the Wong-Baker Faces Pain Rating Scale is also helpful for elderly patients who
may be cognitively impaired. If offers a visual description for those who don't
have the verbal skills to explain how their symptoms make them feel.
Color Scales/Facial
Expression Scales
A numerical pain scale allows you to describe
the intensity of your discomfort in numbers ranging from 0 to 10 (or greater,
depending on the scale). Rating the intensity of sensation is one way of
helping your doctor determine treatment.
Number Scales
With a verbal scale, you can describe the
degree of your discomfort by choosing one of the vertical lines that most
corresponds to the intensity of pain you are feeling. This is a good way to
explain early postoperative pain, which is expected to diminish over time. Your
doctor can use this scale to determine if your recovery is progressing in a
positive direction.
