What to Say When Asked to Rate Pain?

It is so hard for me to rate pain with chronic pain! The MD's ask at hospital what's your pain? I say in chronic pain 8 in a regular person that would be a 16. Comfort level 3-4. This question is so hard for me. Anybody else?

glad you mentioned this and yes ... I find the pain ratings very hard as well; i know that the question and answers give them some kind of guide to work with but I always hate being asked because I never know how to answer in a way that will be helpful in how i'm being treated

The 10 on the pain scale for me is when I had an 9 inch surgery site open up right after staples were removed. 3 for me is almost tollerble When I compare current pain to that pain I really do not have a problem rating it. I always include my example of what 10 equals and have not had problems with people not understanding me.

I have a T-shirt that I wear to medical appointments - it says on it PAIN 40. that makes a useful place to start explaining what I really mean. There are no numbers that accurately describe my pain.

Also, I do a lot of screaming.

AM I the only one that really dislikes being asked what number your pain is?

As a nurse, I am not fond of the pain rating scale. The idea is this: 0 is no pain, 10 is the worst pain you have had in your life, it is unbearable (to you, pain is individual)...
I always try, in addition to using the scale (believe it or not we Have to use a scale, and there is one with faces for those who cannot speak that is not very helpful either, for our documentation and to determine drug dosage)---anyway, I try to have the person also describe the location, quality (sharp, dull, nagging, burning etc), and duration of the pain; and any thing non medical or otherwise that makes it worse or better for them. ...pain, I was taught "is what the patient says it is"...
Sometimes, there are people who are dependent on meds and drug seeking, that is a different kind of pain...& so on...
I hate the scale, it is useful for a few I do suppose.

I never know what number to tell them. I usually just use words like "it's the usual pain", "it's worse than normal", etc. They usually tell me to pick a number. i tell them my "words", and have them pick it for me. It's silly really.
Shinty

I hate having to use a number to rate my pain. I figure my day-to-day pain level would be a 3 or 4 for the average person. Bad days are off the chart for the average person!

I once invented my own pain scale. I don't know exactly what it covered anymore, just that 4 is being unable to not scream, and 5 is going crazy, attempting to knock myself unconscious etcetera.
1 was something like "I'm not engaging in any method to hinder reacting to the pain" such as pushing shoulder blades against each other, squeezing a stress ball, or clenching my jaw.

I simply refused to do a number thingy. I had no idea what 0 was, so how could I rate on a 0-10 scale?

They amputated my leg, so now I just have phantom pain.

Thank you for bringing this up. And thanks to the nurse above who says she is not fond of the rating scale.

Today I went to my primary care provider. As always, I got weighed and vitals taken. As always, since they started this new thing, I am asked if I have any pain. I say, "Yes." Then get asked about the scale. I said, "I don't know." in a kind of irritated voice.

Well, I guess that's not the first time the medical assistant got that response because she didn't blink an eye or lose a beat. I think a lot of people are getting sick of this pain scale. Until today, I've always answered respectfully after trying to pick a fair number. No more. I'm sick of it.

I have chronic foot pain that is making it impossible to walk normally. It's not excruciating, but it is miserably impacting my quality of life. It doesn't hurt as bad as most headaches I've had. But on a scale of what really sucks, this is getting awful.

This whole idea of a pain scale is not working as they thought it would. I refuse to participate anymore.

I get so frustrated with this question because I am used to it ending in a few ways. Either a doctor says "That's too high!" or "you're not symptomatic enough!" which is always charming.

I am usually an 8 or 9 and I don't sugar coat it for anyone anymore, I am tired of doctors not doing their jobs.

Yeah -- it is pretty inaccurate I think

I have chronic pain and sometimes it is better to say 'like being stabbed by a thousand needles' than 8/10

In our ERs there is a 1-5 scale and explanations/pictures of what each means so it is a little easier to get on the same page as the health care workers. But I don't usually get asked that question at my regular doctors or anything. I use "excruciating" for one pain I have but it does not seem to do any good, they don't stop and think about that or do anything differently, they just do their usual stuff and I get the usual excruciating pain and then have to go, "See!?" (it registers on their equipment). I'm waiting until I'm in my 80s and they go ahead and my heart says, "Forget this ****!" from the pain and gives out.

I too find it hard to rate my chronic pain. I'm in pain 24/7. All the time. I don't know life without pain. Its been going on now for at least twenty years now. Pain pills don't help so I drink. Its only 8:30 am and I'm already on my second drink. It is what it is I guess. But on may2nd I go for an epidural pain injection. Let's hope it works.

Good luck on the injections. I've had a number of injections of various sorts to address Post Hernia Repair Pain Syndrome after recurrent bilateral inguinal hernias. I guess a lot gets messed up in there when multiple surgeons have played with your insides.

I'm always a little scared of injections as I know they are meant to stop the pain, but I regularly go through a week or so of "new" pain from the procedure before it goes away and my original pain is addressed...at least temporarily.

First, the "average person's" pain is zero! I can no longer imagine such a day.

Today, my pain is off the chart without managing it with med, ice, heat, trigger point work, stretching, rest, etc. With all that it's a 10 today. (I'm amazed I can sit to be here, but am trying to not lie in bed all day as that increases my pain sometimes.)

Here is one way to describe pain levels.




Here is another. There are some with faces as well. The most important thing in this respect is to make copies of it and make sure all of your doctors are using the same scale when you talk with them. (Or, find out which scale they are using and verify all are on the same page.)

and here is a behavioral scale:

I hate that pain rating question. I get migraines and I'll be shaking and moaning in pain and they ask
it. I also have chronic pain in my neck and all my joints and now a sprained ankle since September that won't heal. To me a migraine is 10 and I just go from there but I try to give other descriptions like " the pain wakes me up at night," or "it's making me nauseous. " because I think the pain scale is kind of subjective.

I have a big problem with the pain scale as well.
I also have difficulties pinpointing sources of pain and in many situations actually detecting certain levels or kinds of pain... which can be confusing to explain to a lot of people unfamiliar with the concept.

But what that can look like is my body might be reacting like I am in pain [my vital signs are elevated, etc], and I can tell I am experiencing discomfort. but I can't quite pinpoint the source and my brain isn't registering it as pain.

Or I can't pinpoint the source because it is a radiating pain to a degree that makes it difficult to narrow down.

Or, what can often happen [probably happens with a lot of people] is the pain LEVEL- what my brain is clearly perceiving as pain may actually be the same from one day to another but my ability to cope is better [or worse] on the second day. The pain may even be worse on the second day, but maybe I had a better breakfast, or I saw my best friend that day, or whatever.

I've taken to doing the following to try to more accurately express my pain and discomfort levels:
I will give a number, but I will usually give a short range [5-6]
I will try to compare to last time if I can remember
As likewater said, I will try to give a specific description of how the pain is affecting my functioning:
"I couldn't sleep last night"
"I had trouble washing my hair this morning"
"My BF had to cut my lunch"

Also as likewater wrote, I will also mention any secondary symptoms/effects the pain creates:
"I'm having trouble navigating my environment because I can't pay attention" [I actually nearly fell down the stairs one morning because of this]
"I'm nauseated"

Finally I will try to describe the pain with a word like stabbing, throbbing, sharp, dull.

I can't always do all of these things because I am not always able to understand the nature of my pain, but I've found these things help somewhat.

Being in constant, terrible pain,, when asked to rate my pain, I always say - on a scale of 1 to 10 its a 20+. Being in constant pain really sucks and with all the drug seeking people out there, most dr's won't prescribe anything more than ibuprophen, or something similar.

I have bulging C1-C5, chronic neck & jaw pain, close to herniated L5, chronic headaches & migraines for day's at a time. I have never had pain before like this till a car accident. I never had to seek pain management in my life. When I was 18 I had to get wisdom teeth removed and the pills made me sick. I am in my 30's and have been bed ridden off & on since 2011.

I had no pain management for roughly 4month's now because my SNRI stopped working while I was still taking it and I landed inpatient @ hospital (worst experience ever). I had to go to hospital cause my psych was out of the country for a week and half.

I had a pain management MD until I went in hospital, I got out of hospital and pain MD red flagged me! He did not listen to why I was in hospital he just had his mind made up that I was suicidal. I went in to see him 2 times and he said "nope he does not feel comfortable". The 3rd time my mom went with me to explain everything and to tell him that if he did not feel comfortable than she would bring me my pills daily. Nope still not comfortable!!!

So I went to Pdoc 3 times as well and he would only give me Tylenol 3 and told me to take as much as needed(not good on Liver etc). The Pdoc & nurses know me very well since the car accident and they never ask me my pain level cause they could tell from my behavior was horrible.

The tylenol 3 was not working and I started to get sick from the codeine. By the 3rd visit my mom went with me to tell the Pdoc that she see's me and the pain I'm in, and this is what could result in me killing myself from the pain. At this point I could barely walk or talk anymore. The nurse & Pdoc never asked me my pain the years they have seen me since accident, because it was obvious!!! Finally my Pdoc listened to my mom and I finally got back to pain management regimen.

I am happy to say that my chemistry does not go well with antidepressants and I do not have anymore of that trial & error going on! I just wanted everyone to know that to be in debilitating pain and to be neglected by MD's is the WORST thing! Makes you lose hope and almost life. I wish the MDs would just observe behavior, diagnosis, background medical history, and movements so they could then see the real pain.

I might be naive in some people's eye's but I do not know how people would be able to fake pain if the MDs just took a few minutes to assess the patients behavior, diagnosis, background of pain, movement instead of a stupid scale.

I just had to share my pain story and the way that no scale can be better than observing.

Pain scale is laughable. Pain is on a sliding scale and it different to each individual. The only thing left for me is another epidural and since that's a good $1000 between doctor and anesthesia it's not an option. Something like Vicodin or percocet would be much cheaper in the interim but I've given up asking for them. It's just not worth the disgusted looks I get.

Yes! I could rate mine at 12 some days. Besides it's all relative and subjective. Different people have different tolerances. To a woman who's had kids, there's probably nothing more painful than that (I'm guessing - I don't have kids). When I was in the hospital for a staph infection, I had a nurse ask me what my pain goal was. I said, how about to NOT be in pain?! What a stupid question to ask a patient!

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You did a great job describing the lack of concern the majority of doctor's show these days for someone in pain.

I saw a pain doctor for 6 years due to being hit on the side of my face by a horse, which knocked my head into the trailer and I received 10 staples, then I was thrown from a different horse, which resulted in a concussion, not because I hit my head, but because I landed so hard on my lower back that it "shook" everything up, the way I was told.

When I'd go for my appointment with the pain doctor and he'd ask what my pain level was I would tell him, if the number was on the chart, say an 8, if it was worse I'd tell him the chart only went to 10 and my level of pain was off the chart.

I stayed on Norco and codeine that was made by a pharmacist for the entire time I saw this pain doctor. I refused to let them give me injections, there are way too many things that can go wrong.

In 2010 I decided to take myself off of everything and I had no more pain until 2013.

Now instead of the terrible pain I had in my neck and shoulders, my lower back is extremely painful, to the point when I go to the grocery store I may not be hurting, but somewhere while I'm there the pain will start.
One time it was so bad that I made it to the check outline and had to get on my knees.

I was sent to an orthopedic surgeon who after taking an x-ray said I had degenerative scoliosis and wanted to inject me with steroids. I refused, and I guess like most doctors he wasn't listening when I told him I have been to 6 physical therapists, spent 6 months at the last one and they didn't help my neck.
I told him I went on my own in 2013 to a massage therapist for my back, but once I walk out and drove home the pain would come back.

He said I needed to go to physical therapy 4 times a week for 5 weeks. He also gave me prescriptions for a new medicine that is only ibuprofen with something mixed in to help your stomach and for Flexeril, which I had taken a long time ago. I did not get either one filled.

Doctor's, especially ones who specialize anything seem to have the attitude that no matter what you tell them, even if they are listening to you, what they want to do is the only thing that matters and nothing you can say will change their minds.

I've had it with all of them. I have been trying to find a TENS or a PENS unit, but so far it seems the only way to get a decent one is to have a doctor write a prescription for one and then go to a physical therapist to learn how to use it.

At this very moment if I bend to brush my teeth or if I am standing and take a deep breath I just want to fall on the floor and not move at all.

I do have some Norco left over and I've been taking a half of one in the morning and it gives me a little relief. I am hoping before they are gone I can find a doctor that actually listens to what I am saying. HA!!

I hope you can find someone to listen to what you say and actually understand enough to give you some relief.

Its like once a doc finds out you have a psych disorder, everything you say is immediately discounted. I'm in my 40's and it's ridiculous that my mom has to go to my appoints to explain that my pain is real. I have a great psych now, but in general I HATE docs. They should know better than anybody else what we go through mentally and treat our pain as legit.

Haha, lovely. Then the patients probably get irritated at YOU for that annoying scale you HAVE TO use.

BTW, I cannot stand the scale either. It's up there with the dumbest things I've ever seen at a doctor's office.

Let me give a big OH YEAH to that! I've seen docs' entire attitude change when they see I'm on antidepressants. They become totally dismissive and blame the pain on my depression. My pdoc is great. He helps me cope with both my depression and fibro.