IMHO, proper understanding of the pain scale is critical. Unfortunately, it's misunderstood by many patients and thus, may be responsible for incorrect treatment. Good congruency between one's pain and the pain scale is very important. One of the biggest mistakes CPers make, is not correctly communicating their pain. PMs use a common scale of 1-10 to diagnosis a patients pain level, and will put a lot of emphasis on this rating as to decisions they make re: possible treatment plans.
The pain scale, working backwards:
- A "10" is the worse pain imaginable. Most people have never experienced a 10, so Docs wouldn't take someone serious if they report a lot of 10s.
- "9" is very serious pain...Something like post surgical, or very debilitating type pain that cause one to be bed ridden.
- "8" is very serious pain that causes one to miss work or school and requires serious medication. Physical activity is often significantly limited as a result. Even reading can be difficult.
- A "7" is bad pain, but some may try to go to work or school, but may not accomplish much. Discomfort level is high. 7's cause mood fluctuations and the pain is very bothersome.
- When working up from the bottom of the scale, "6"s are where the pain starts to get serious IMHO. 6's can often cause disruptions in people's lives. Pain at 6 and above can cause mood swings, absenteeism, and is a general nuisance.
- "5" is where many professionals will define pain as starting to be "distracting." For those with very serious conditions, most PMs will set an expectation that severe chronic pain can be acceptable around a "4" or "5"....Many will say that one should be able to live with pain around this area, especially if they were once at a much higher level.
- Most PMs will consider pain below 5 as minor in nature, and may not require a pain mgt specialist. A lot of pain below 5 can either be handled by a GP, or even OTC meds, depending on the type of pain, and the needs of the patient.
The above is by no means the gospel. However, I would say it does a pretty good job of describing pain in general. Again, one of the biggest mistakes a CPer makes, is not correctly assessing their pain. Most patients underestimate their pain, thus causing under treatment. If you don't communicate your pain correctly, the PM won't be able to help you as much as he/she would otherwise.
However, it's equally important that one doesn't overstate their pain either, or you may not be taken seriously. For example, if you're joking around with the Doc about something that was on the news, or last nights American Idol show, chances are you don't have an "8" or "9."
A general rule of thumb in PM is for treatment to reduce one's pain by at least 30%. Applying this to the pain scale, if one starts at fairly regular level of 7 or 8 (before PM intervention), then a level around 5 would be a reasonable target goal. It's very possible, however, that pain responds much better to treatment, and one's pain is lowered by a very large amount.
Some pain on the other hand, is so great, that only a modest reduction is possible. These cases are usually very challenging for PMs and often result in high levels of narcotic therapy.
Lastly, some PMs will use a 1-10 scale, with pictures of faces corresponding to each #. This scale should be considered nearly identical to what I outlined above.