Editor’s Note: This article was originally published in 2015, and its message is as timely today as it was then. As Karen originally stated, “Because pain is subjective, it is difficult to explain what you’re feeling to another person—even your own doctor. The pain scale may not be ideal, but it’s the best tool we have right now.”
As a fibromyalgia patient, you’ve probably had doctors or nurses ask you, “How would you rate your pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine?” That sounds like a reasonable question—except for the fact that no one ever tells you what those numbers mean.
When faced with that question, often panic sets in and your mind starts racing. What number should I say? If the number is too low, he won’t understand how much I’m hurting; but if it’s too high, he’ll think I’m just trying to get drugs. How can I be sure that what he thinks the number means is the same as what I think it means?
In an effort to help remedy this situation, I researched several interpretations of the pain scale and have compiled what seems to be the most commonly accepted description of each number on the scale. If you want to be sure you and your doctor are speaking the same language, give him a copy of this pain scale so he knows exactly what you mean when you rate your pain.
0 – Pain free.
|Mild Pain – Nagging, annoying, but doesn’t really interfere with daily living activities.|
1 – Pain is very mild, barely noticeable. Most of the time you don’t think about it.
2 – Minor pain. Annoying and may have occasional stronger twinges.
3 – Pain is noticeable and distracting, however, you can get used to it and adapt.
|Moderate Pain – Interferes significantly with daily living activities.|
4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting.
5 – Moderately strong pain. It can’t be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.
6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating.
|Severe Pain – Disabling; unable to perform daily living activities.|
7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep.
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8 – Intense pain. Physical activity is severely limited. Conversing requires great effort.
9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably.
10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain.
Avoiding the Pitfalls
When rating their pain, the most common mistake people make is overstating their pain level. That generally happens one of two ways:
- Saying your pain is a 12 on a scale of 0 to 10.
While you may simply be trying to convey the severity of your pain, what your doctor hears is that you are given to exaggeration and he will not take you seriously.
- Smiling and conversing with your doctor, then saying that your pain level is a 10.
If you are able to carry on a normal conversation, your pain is not a 10—nor is it even a 9. Consider the fact that natural childbirth (no epidural or medication) is generally thought to be an 8 on the pain scale. Just as with the first example, your doctor will think you are exaggerating your pain and it is probably not nearly as bad as you say.
Because pain is subjective, it is difficult to explain what you’re feeling to another person—even your own doctor. The pain scale may not be ideal, but it’s the best tool we have right now. Researchers are working on developing tests that one day may be able to objectively measure the degree of pain we’re experiencing. But until those tests are perfected and become widely available and affordable, we’ll have to make the best use of what we have.
Download a free, printable version of the pain scale right here
Karen Lee Richards is ProHealth’s Editor-in-Chief, as well as being the Editor of both the IBS and Weight Loss HealthWatch newsletters. A fibromyalgia patient herself, she co-founded the nonprofit organization now known as the National Fibromyalgia Association (NFA) in 1997 and served as its vice-president for eight years. She was also the executive editor of Fibromyalgia AWARE magazine. After leaving the NFA, Karen served as the Guide to Fibromyalgia and Chronic Fatigue Syndrome for the New York Times website About.com, then worked for eight years as the Chronic Pain Health Guide for The HealthCentral Network before coming to ProHealth.