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Old 05-24-2008, 03:55 AM   #1
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The 1-10 Pain Scale...

...seems totally subjective. My 3 can be your 8, and vice versa. While helpful in tracking changes in pain experienced by one person, it seems tricky to identify how much pain someone is actually experiencing at the outset when using this scale.

So I though we'd devote a thread to pinning down what the various levels of pain mean. I think it would help many of us talk to our doctors more effectively, since this is the language of PM, and communicating well is the key to good treatment.

 
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Old 05-24-2008, 06:39 AM   #2
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Re: The 1-10 Pain Scale...

That is why we have the 1-10 scale. To help communicate with the doctors just what our pain is. I don't agree that your 3 could be my 8. Your 3 is just that your 3. My 8 is my 8. It is totally how the pain is affecting me. It doesn't matter what other people perceive as a 3 or 8. When the doc asks it is about me and what my pain level is.
Of course this is just my opinion.
Fred

 
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Old 05-24-2008, 10:16 AM   #3
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Re: The 1-10 Pain Scale...

hi mark76, i know what you mean, i'm learning to try and tell them like if i'm at my 8 then i tell them what that means to me unable to eat , sick to my stomache hardly able to speak at least not more then a whisper etc... other wise there personal scale maybe diff. and they can't remember everybody's diff personal scale deff. even though when your in high pain the last thing you want to do is go over that i agree you really have to communicate your personal scale or you may not get the help you need...just my thought
ladybuggy

 
Old 05-24-2008, 11:40 AM   #4
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Re: The 1-10 Pain Scale...

Personally I cannot stand the pain scale. No doctor can explain how to use the pain scale or what is a 5? Or a 8? Is it when I run to get my medicines because I feel like an addict who is feeling so much pain that I have to have them now? Is it when I just feel blah and tired and achy? I really have no idea how to articulate my pain number. I do totally agree that ones 3 is another's 8. For me a 8 4 years ago is maybe a 4 now since I am so used to living in pain that I have become accustomed to to it. So I never know what to tell the doctor. I have to take multiple different medications to feel good, but what is good? A 3,4,5? Some days good is just being able to do stuff and not dread it. I always have pain, but somedays it can be less then others. I fear telling the doctor I have a 3 one day and he decides I do not need as much medication as I have now and then that 3 goes to a 7 or 8 the next day. Who knows I sure don't!

 
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Old 05-24-2008, 11:43 AM   #5
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Re: The 1-10 Pain Scale...

Backinthesaddle , well said
ladybuggy

 
Old 05-24-2008, 11:53 AM   #6
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Re: The 1-10 Pain Scale...

Hi Mark, what a good topic to bring up. What I think happens is that alot of times people want to say its an 11 or 12 on a scale of 1-10 to say it's really really bad. But then that means it's a 10 and a 10 is supposed to be the worst pain ever. For me that's when I was writhing on the floor in agony. What happens is someone goes in and sits quietly on the table, is somewhat pleasant but uncomfortable and when asked what their pain level is says 8. Sometimes I think credibility is lost when maybe it's just not understanding the scale.

Maybe instead of changing the system, it would be helpful when people start pain management that they go over that chart with their docs so they both are on a consensus of what a 5 means etc. I know for me personally I used higher numbers until I had that writhing pain, then I was like WOW now I know what a 10 is.

Anyway, JMO
Thanks
Melissa

 
Old 05-24-2008, 01:36 PM   #7
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Re: The 1-10 Pain Scale...

mark76,

What a great topic for a thread. Communication is the key and what's more important than effectively communicating with your doc the level of your pain?

Having said that, I completely agree with Fred:

Quote:
Originally Posted by Arthr Itis View Post
That is why we have the 1-10 scale. To help communicate with the doctors just what our pain is. I don't agree that your 3 could be my 8. Your 3 is just that your 3. My 8 is my 8. It is totally how the pain is affecting me. It doesn't matter what other people perceive as a 3 or 8. When the doc asks it is about me and what my pain level is.
Of course this is just my opinion.
Fred
First of all this is a 0-10 pain scale. 0=no pain. 10=the worst pain you can imagine. Everything else is part of a range between the two.

One's pain level is always personal. It's a way for a doc to get a feel for what kind of pain intensity a patient is experiencing. And it's not measured at a single point in time, like at a doctor appointment. Docs want/need to know averages, highs and lows. At each appt with my PM I'm asked to complete a chart showing what my average pain score was for the last week. Then I indicate what it was at its worst, and how often it reaches its worst. I am also asked how satisfied am with these scores and how much of my total pain is being relieved by my meds/therapy. Finally, I am asked about side effects, which ones I experience and how badly they affect my quality of life. Oh, I am also asked to indicate how certain items are since my last visit, like family relationships, sleep, activity, quality of life, etc, and my choices are the same, worse, or better.

Taken together with the scores, this questionnaire provides my doc with a snapshot of how I'm doing and how well her treatment is working.

However, your measure of what a 5 is has nothing to do with what a 5 means to me. We are not compared to one another. And these numbers do not stand alone. They are compared to other times in which we've used the scale. Of course, the first time we see the PM doc, these numbers are used to get an overall idea of pain intensity. Thereafter, the scale is used to compare previous scores to present scores. Good PM docs have learned that one's appearance is not necessarily indicative of one's level of pain. Some folks have a very high tolerance for pain, while others howl at a 3. I may show no outward appearance of pain at my estimate of 8 on the pain scale, while another may be rolling on the floor in agony at their 8. Now, if I were rolling on the floor in agony I'd have no trouble reporting a 10. We are all different. The look on our faces can have nothing to do with how much pain we're in. Dealing with pain is a learned response, and many PM patients have learned to live with high levels while supressing painful expressions.

It is important to also communicate with your doc what your numbers mean to you. In other words, I might tell my doc that at a 7 I simply cannot tolerate doing chores or enjoying an outing with my family. That if I were at a 4 I could probably even work out, and go on that vacation next month with my wife. That at a 6 my quality of life is really unacceptable and could we please do something to get me to a 5? These qualifications used together with the numbers in the scale provide the doc with an overall picture of what pain means to you, and what levels would indicate relief.

The 0-10 scale is simply a tool, and I believe a good one at that. My doc and I have an agreement that our goal is to keep me at a 5 or lower. Anything above a 5 and we work together to analyze why the number is elevated and how to get back to a 5. I came in last week and noted that my average score was a 6. However, I also told her that my activity level had increased and that was causing the elevated number. I also told her that I did not wish to increase my dose of LA or BT meds because I expected the number to be higher because of activity - that I was choosing to do more and was willing to pay the price. I could always back off and return to a 5 all on my own without more meds.

This is how I see the scale.

steve

Last edited by forginon; 05-24-2008 at 01:41 PM.

 
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Old 05-24-2008, 06:03 PM   #8
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forginon HB User
Re: The 1-10 Pain Scale...

That's not the standard 0-10 pain scale.

The standard scale is referred to as "The 0-10 Numeric Pain Intensity Scale."

0=no pain whatsoever, and 10=the very worst pain one can imagine. The remainder form a range between the two.

steve

 
Old 05-24-2008, 06:13 PM   #9
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Re: The 1-10 Pain Scale...

Alan, is that the scale your doctor uses? It would seem that using that scale, pretty much every chronic pain patient would be a 10 (or higher), whereas using the standard 0-10 pain scale, very few chronic pain patients, even without medication, would register at a 10.

 
Old 05-24-2008, 06:31 PM   #10
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Re: The 1-10 Pain Scale...

Good job Steve. I wish I'd put it that way. Then again, with my mind or lack of it I probably couldn't put it that way if I tried. As for what a 10 is....to me a ten is when I'm sitting in my recliner with the phone in my hand trying to decide if it's time to call 911 or not. My doctor agrees that is a ten. I was told at my first PM meeting that the best they could ever get me would be a 2. That is aware of the pain but not...I forget what the rest of it is. I seem to be spending way too much time in the 6/7 zone. It's about time to have that little talk with the doc.
Fred

 
Old 05-24-2008, 06:36 PM   #11
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Re: The 1-10 Pain Scale...

Quote:
Originally Posted by Boxerluver View Post
I know for me personally I used higher numbers until I had that writhing pain, then I was like WOW now I know what a 10 is.
for me it was the only time I had a kidney stone-that forever will be my 10

Last edited by eyesworld; 05-24-2008 at 06:38 PM. Reason: sp

 
Old 05-24-2008, 07:10 PM   #12
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forginon HB User
Re: The 1-10 Pain Scale...

Quote:
Originally Posted by Arthr Itis View Post
Good job Steve. I wish I'd put it that way. Then again, with my mind or lack of it I probably couldn't put it that way if I tried...
Fred
Fred,

You already did as good a job as I did - that's why I quoted you in my post. You wrote in a few lines what it took me half a page to write.

You sell yourself way too short.

steve

 
Old 05-24-2008, 07:14 PM   #13
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forginon HB User
Re: The 1-10 Pain Scale...

Quote:
Originally Posted by eyesworld View Post
for me it was the only time I had a kidney stone-that forever will be my 10
From everything I've heard passing a kidney stone is definitely a 10.

I am very reluctant to ever assign a 10 to my pain. But, there have been a few occasions. My gall bladder attacks definitely took me to a 10, and so did my small bowel obstructions. Other than those times I usually top out at around 8.

steve

 
Old 05-24-2008, 07:30 PM   #14
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Re: The 1-10 Pain Scale...

Ex,

Yep - I think we view this the same.

The three times I mentioned were at a 10, in all three cases I desperately wanted to pass out. Unfortunately, in all three cases, I remained conscious. I really don't recall ever assigning anything a 9. And, like you, 8 is where I top out most of the time. I can handle 8s, but I'd prefer not to stay there long.

I appreciate you sharing this. It's helpful to hear what those you respect consider some of these levels to be in their experiences.

steve

 
Old 05-24-2008, 08:12 PM   #15
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Re: The 1-10 Pain Scale...

Yes...Looks like we're lock in step.

I typically stay around a 6 or 7. When I'm @ a 5, I actually feel good (even though I hurt)....A matter of perspective I guess. When I hit 8, I'm housebound....And couch bound. Thank goodness for laptops!

Ex

 
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