Pain level scoring?? - Pain Management Message Board

robochick · 03-01-2009, 03:23 PM

hi, I've been attending a pain releif clinic for 10 years and never really been able to understand the pain level scoring thingie!!! I've never had anybody to ask and was too embarrassed to ask at the pain clinic, could any body please, please explain this too me?????? Also, how much is too much pain, what do you do when you have done everything to stop or manage your pain but it still persists!! my routine when my pain in extremly bad is, make sure am upto date with my buprenorphine patch, take extra pain killers , then I'll have a hot bath to try to relax my back muscles, then put my TENS machine on, then put my heat pad on, then I'll try my best to get as comfy as possible, try and control my breathing so I don't have a panic attack. What do other people do once they have done their pain releif routine?? I feel like am waiting for next christmas on boxing day, just sat or laid there waiting for the pain to subside!! Is there anything else that I can add to my routine for more pain releif??? Please Help xxxxxxxx

pooby · 03-01-2009, 03:40 PM

0 Pain Free No medication needed.
1 Very minor annoyance - occasional minor twinges. No medication needed.
2 Minor annoyance - occasional strong twinges. No medication needed.
3 Annoying enough to be distracting. Mild painkillers are effective. (Aspirin, Ibuprofen.)
4 Can be ignored if you are really involved in your work, but still distracting. Mild painkillers relieve pain for 3-4 hours.
5 Can't be ignored for more than 30 minutes. Mild painkillers reduce pain for 3-4 hours.
6 Can't be ignored for any length of time, but you can still go to work and participate in social activities. Stronger painkillers (Codeine, Vicodin) reduce pain for 3-4 hours.
7 Makes it difficult to concentrate, interferes with sleep You can still function with effort. Stronger painkillers are only partially effective. Strongest painkillers relieve pain (Oxycontin, Morphine)
8 Physical activity severely limited. You can read and converse with effort. Nausea and dizziness set in as factors of pain. Stronger painkillers are minimally effective. Strongest painkillers reduce pain for 3-4 hours.
9 Unable to speak. Crying out or moaning uncontrollably - near delirium. Strongest painkillers are only partially effective.
10 Unconscious. Pain makes you pass out. Strongest painkillers are only partially effective.

PNo · 03-01-2009, 04:58 PM

Funny you posted this because right now I am sitting here trying to distract myself from my own pain. I bet most people forget the pain levels and what it really means after having to deal for long periods - like you for 10 years. I only hope that by then I have more control of my own situation. I usually under value my pain because I am always reluctant to acknowledge it to myself like I am "givin in". In my PM they only use the happy face 1-10 scale so you don't have to read the words and admit how much you really hurt. If you actually look at the words I find myself having to admit the pain. My goal is to keep around 5's on average, on a rare lucky day I can get as low as 3, on bad days it can go in the 8-9s. Thankfully I haven't had any 10s for a while but did have 9 day on thursday. I find as I am in the 7's I tend to be crying (maybe that is like your "panic attack"), I looked at those statements from Pooby and the ones I was looking at were 7-8-9s. I never have complete "relief" and I am on fentanyl - what it does is bring it down to keep me in the 5s. I also am pretty reluctant to move up on nore patches and just try to manage - it is scary to me to think that tolerance keeps building and someday there might not be relief without being in a complete haze. So I would rather manage it with the lowest amount I can get by with for now. I think that is a PM goal anyway is not to be 0 but to at least cut pain in half.

One thing I found useful is guided imagery with the pain psychologist - I learned it myself, but I think I need to go in for a touch up on the skills. If you haven't tried this you might! I do everything you say, and have burned out so many heating pads - I own stock in the company - try distracting things like music - or computer - or whatever is your thing. When all else fails, I just try to go to sleep for a nap and see if I wake up feeling better.

There are people that get pain pump implanted and that works for many - have you looked into that as well as the scs?

megss · 03-01-2009, 06:48 PM

That is depressing. I just realized I never get below a 6, and spend a lot of time in the 7,8,9 range.

My new routine to manage my pain is to take my medication on a regular schedule. Keeping on a schedule with these things helps a lot. I also spend a lot of time on my ice pack. Deep breathing helps a lot, because once I start moaning and crying my muscles tense up which makes it worse. Try playing some relaxing music. Do you have one of those clocks that plays nature sounds? That helps me relax.

I am sorry you are in so much pain. It is really terrible to have to live like this.

jennybyc · 03-01-2009, 06:49 PM

I am a big fan of finding a therapist who deals with chronic pain. They can teach you all sorts of emotional coping skills as well as how to manage your family, friends and work. And it's helpful if you are applying for SSDI.

As for the pain scale, I have my own scale. I had both knees replaced at the same time. The post-op pain is excruciating to say the least and it took me all evening to ge tto sleep after 8 hours in the OR. So what happens? The nursing staff wakes me up at midnight to clean me up. They had been too busy all evening. Well, I had maxed out my PCA already and they couldn't give me anything extra so I ended up with massive breakthrough pain. They paged the pain doc on call for 3 hours....she had turned off her pager to get some sleep. I was sobbing and near delium from the pain. My ortho had warned me he had seen people have psychotic breaks from the pain so he was "making sure" I was well medicated. He didn't count on stupid nurses and a lazy pain doc.

They finally got the okay to inject Fentanyl directly into my spine and only after a second injection could I rest. The next day they changed the PCA mix to a higher percentage of marcaine with the Fentanyl.

That became my "10". So now everything is relative to the night I had to put up with the post-op pain of 2 TKR's and no pain meds. Doubt I'll ever hit a 10 again(I hope).

gentle hugs...............Jenny