A pain scale is typically a visual method that allows you to systematically track your pain, its intensity, and other symptoms. They’re often based on cartoons or numbers. These scales can be self-reported verbal rating scales, as in you explain your pain symptoms according to the measurement given. They can also be judged by behavioral or observation (especially in the case of kids or people who are unable to speak). Pain scales are an excellent way to better share how you’re feeling with your doctor. They can help you get a better diagnosis and treatment for your pain. Here’s 15 of our favorite pain scales, with advice at the end for finding the best one for you to use.
What is a pain scale?
Pain assessments and scales are the bestway to communicate with your doctor what you’re feeling and how bad yourpain is. And they can track your pain day over day, especially when used in combination with a pain diary app or journal. They can be a scale from one to ten, with ten being the worst pain imaginable and one being no pain at all. These scales can also rely on visual indicators or facial expressions to judge pain. Or, they can be personalized interpretations of how pain affects you in your life, always there in your pocket with a pain app like PainScale.
But, as always, pain is subjective. You have to find a pain measurement that works for you, consistently and easily.Seddon R. Savage, MD, incoming president of the American Pain Society and an adjunct associate professor of anesthesiology at Dartmouth Medical School in Hanover, N.H. explains how to conceptualize the top of your pain measurement.
“I ask people to remember the worst pain they’ve ever experienced in their lives. It might be akidney stoneorchildbirth. That level of pain becomes the benchmark to which we compare the current pain… I also ask people to show me on the pain scale what an acceptable level would be. The fact is that we probably can’t bring chronic pain down to zero. But we can aim for a level that still allows you a good quality of life.”
We’ve pulled together a list of 15of our favorite pain scales to help you get started. The right one will be very accessible and will just “fit.” It will make sense to you and how you experience pain. Remember, a pain assessment scale is just a tool and it must work for its user. If a one to ten scale doesn’t help you explain your pain, a color scale for pain or facial scale might.
Types of pain scales
There are many types of pain scales, including:
- 1-10 pain scales
- Faces pain scales, typically the Wong-Baker FACES® pain rating scale
- Global pain scale
- Visual analog pain scale
- McGill pain scale
- Mankoski pain scale
- Color scales for pain
- Pediatric pain scales
- CPOT pain scale
- Patient-created personalized pain scales
We’ll cover each of those in more detail in this post.
1. Pain scale 1-10
The most common scales for pain encourage the patientto identifytheir pain between one to ten. If you’ve been to a doctor about your pain, you’ve likely used this scale before. This scale issimple, it’s effective, and it works for many patients. However, the scale can be limiting to otherpatients who don’t quite understand what a six means versus an eight.And it’s frustratingly subjective, meaning that different people will have different scores within the scale itself. And different doctors will interpret your answers differently. The Stanford version of the pain scale from one to ten, however, goes a good way towards clarifying this pain measurement.
2. Faces pain scale, or Wong-Baker FACES® pain rating scale
A scale that relies on faces can be incredibly helpful when diagnosing pain in children. But it can also go a long way towards helping your pain doctor understand the level of your pain during a visit. The faces pain scale that many people are familiar with is related to Wong-Baker’s FACES® pain rating scale. As you can see, it uses a one to ten scale to judge pain and then correlates facial expression with that.
However, this common scale for pain may not be descriptive enough for most patients and it’s typically not helpful for patients with autism.
(Video) “Pain Assessment” by Catherine Dowling for OPENPediatrics
3. Global pain scale
Pain Doctor’s own global pain scale is a unique diagnostic tool because it focuses both on physical pain and how that pain has affected a patient’s life. Unlike numeric or visual analog scales, the global pain scale is a more thorough screening tool to assess:
- Current pain levels
- A patient’s emotional well-being
- Clinical outcomes
- A patient’s ability to engage in activities of daily living
While it’s used by doctors to assess pain, it’s also a great tool for you to use to track your painevery day. It only takes a few moments to answer the questions and can give you a quick overall score to determine if your pain is getting better or worse.
4. Visual analog pain scale
A visual analogue scale, or VAS, is a tool that dispenses with numbers for measuring pain. It recognizes that many patients don’t experience pain in discrete units like numbers, but in a variable way that exists on a sliding scale. A pain VAS allows patients to mark their pain intensity on a continuum. Most are straight lines of a fixed length, though some can have middle points or meter-shaped scales.
5. McGill pain scale
If you suffer from CRPS, the McGill Pain Index may provide a better way to track and explain your pain. Instead of fixing pain intensity only to a number, it compares it to other injuries or types of pain to help quantify it. It incorporate sensory qualities, affective qualities of pain, and evaluative issues to help pinpoint the intensity of pain. The Index, first created in 1971, continues to bea very valuable, reliable, and useful way to measure pain and it’s the leading CRPS pain scale.
6. Mankoski pain scale
The Mankoski pain scale incorporates a numerical pain scale, along with brief descriptions, to help categorize pain. It goes one step further though and explains that pain in relation to how pain medicines either help or don’t help the person’s pain.
7. Color scale for pain
Color pain scales are, like many on this list, another way to help children judge their pain levels. But for many who are visually-inclined, colors may also represent a really powerful way to associate and understand your pain. For children, this scale is usually shaped like a thermometer, with darker red colors indicating more pain.
8.Pediatric scales for pain
The Oucher pain scale is another tool that was used to help children communicate their pain. It uses a number scale for older children and uses pictures for younger children to point to explain their pain levels. Likewise, the FLACC pain scale uses a younger child’s facial expression, leg movements, activity, crying, and consolability to categorize the child’s pain.
(Video) Glasgow Coma Scale made easy
9. CPOT pain scale
The CPOT pain scale is another tool doctors use to judge pain in patients. It is typically used with patients who are unable to report their pain themselves, and is based on observation. It helps clinicians judge a patient’s pain based on their:
- Facial expression
- Body movements
- Muscle tension
10. Hyperbole and a Half pain scale
Chronic pain patients know how life-saving humor can be. Hyperbole and a Half is a famous blog that uses humor to approach tough topics like mental health and pain. In one post, they took on the difficulty of clinical scales for pain and put their own spin on it. Many patients love their explanation and feels like it better matches their own experience for pain. Print it out and take it with you to show your doctor during your appointment for a good laugh. (Note: there is some cursing in the post.)
Like the Hyperbole and a Half pain scale, some pain patients have created their own scales to evaluate and categorize their pain. These range from amazing color-coded diaries to humorous takes on pain.
11. Color-coded numerical pain scale
This numeric ratingscalewas shared by a fibromyalgia patient and uses both colors and physical descriptions to help them categorize their pain. By using something like this consistently, you can help better explain your pain to your doctor and track how it’s feeling on that day. This pain inventory allows someone to talk about when their pain is mild or requires urgent critical care.
12. Sensory pain scale
For some patients, explaining the type of pain they’re experiencing is best explained by talking about how the pain feels, not to what degree. This written scale incorporates descriptions for types of pain ranging from industrial pain to cramping pain to spasms.
13. Humorous scale for pain
This pain scaleuses humor to showcase how a person is experiencing pain. It’s largely silly, but is a great way to get the conversation going about your pain.
14. Personalized scale
Even though this scaleis similar tomany of the others on this list, we thought it was important to show that yes, you can and should create a scale for pain that works for you. It doesn’t have to be fancy. This pain inventory helped this patient accurately track their pain according to how they were feeling and how their pain affected them.
(Video) Comparison: Human Pain
This same patient then used a daily tracker to monitor her pain levels. You can see a great example of that in the image below. For visual people, this is a fantastic way to quickly understand and see pain changes over time.
15. Randall pain scale
A scale that actually works is the best pain scale there is. To that end, the Randall Chronic Pain Scale is a tool for putting your own words to a personalized scale. It uses a numeric, color-coded display to help you track and pinpoint your pain that day, while asking you to describe exactly what each of those ratings mean to you. Then, once you have it put together, you can use it going forward.
How to find the best pain scale for you?
As noted at the beginning, pain is subjective. Accurately reporting that pain to a health care professional can be difficult.We believe that creating your own scale can help you better pinpoint exactly how your pain is affecting you and what it feels like.
Overall, we suggest using one of the clinical models that best resonates with you, whether that’s a series of direct questions like in our global scale for pain or a visual representation by colors. You can also create a hybrid scale that incorporates multiple measurements into one (like numbers and colors).Then adapt it for your own benefit. Use color and humor and more specific descriptions as you see fit. You can find a longer list of clinical scales in use here.
You can avoid some of the pitfalls of using a pain assessment by following the advice on ProHealth for fibro patients.
Make a scale that works for you, and you’ll be much more likely to use it. And, when it comes to seeing your doctor for help in treating your pain, they’ll have a lot more information to work with. To get started on your own journey towards diagnosing the cause of your pain, and getting treatment for it, click the button below to find a certified pain specialist in your area.
(Video) 18. Pain assessment tools
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Numeric rating scales (NRS)
This pain scale is most commonly used. A person rates their pain on a scale of 0 to 10 or 0 to 5. Zero means “no pain,” and 5 or 10 means “the worst possible pain.”
What is the 10 point pain scale? ›
Most pain scales use numbers from 0 to 10. A score of 0 means no pain, and 10 means the worst pain you have ever felt.
What should I not tell my pain management doctor? › Don’ts: Things Pain Patients Wish Doctors Would Avoid
- Don’t label patients. …
- Don’t tell patients the pain is ‘in our heads. …
- Don’t tell us to just ‘live with the pain.
What is the most valid measure of pain? ›
Because pain is subjective, patients’ self-reports provide the most valid measure of the experience. The VAS and the MPQ are probably the most frequently used self-rating instruments for the measurement of pain in clinical and research settings.
What is the highest pain level? ›
Pain level ten means unimaginable pain. This pain level is so intense you will go unconscious shortly. Most people have never experienced this level of pain. Those who have suffered a severe accident, such as a crushed hand, and lost consciousness due to the pain and not blood loss, have experienced level 10.
How do doctors measure pain? ›
Numerical Ratings Scale (NRS)
The most commonly used pain scale is the NRS or numerical rating scale. Doctors ask their patients to rate their pain from 0 to 10 with 0 being no discomfort and 10 being the worst pain imaginable, Dr. Dickerson says.
How much pain is too much pain? ›
Severe Pain.
When it intensifies to level 8, pain makes even holding a conversation extremely difficult and your physical activity is severely impaired. Pain is said to be at level 9 when it is excruciating, prevents you speaking and may even make you moan or cry out. Level 10 pain is unbearable.
Is there an accurate pain scale? ›
“Pain scales are absolutely unreliable,” said Dimitry Arbuck, MD, president and medical director of the Indiana Polyclinic in Indianapolis, Indiana. “What’s completely missing from pain scales that are typically used, are descriptions.
There are many different kinds of pain scales, but a common one is a numerical scale from 0 to 10. Here, 0 means you have no pain; one to three means mild pain; four to seven is considered moderate pain; eight and above is severe pain.
Is 7 moderate or severe pain? ›
The meaning of some pain intensity levels is clearer than others. For example, levels of “7” or higher for either average or worst pain are often classified as severe, and pain levels of “8” or higher are always classified as severe (e.g., 10, 20, 23, 28).
How many pain scales are there? ›
Healthcare providers have at least 11 types of pain scales to choose from. They generally fall into one of three categories: Numerical rating scales (NRS): Use numbers to rate pain.
How is chronic pain measured? ›
The foundation of effective chronic pain management includes interviews, physical assessments, reviews of medications and medical and surgical procedures, a psychosocial review, a review of the patient’s physical environment and appropriate diagnostic investigations.
What is the most widely used pain questionnaire? ›
The McGill Pain Questionnaire (MPQ) (Melzack 1975) is the most frequently used questionnaire for the multidimensional assessment of pain.
Is there a machine that can measure pain? ›
The eEgg can be considered as an usable device for the measurement of pain that can be employed in further clinical and therapeutic settings.
Is there a maximum pain we can feel? ›
Pain tolerance is the maximum amount of pain a person can withstand. There’s a threshold where pain just becomes too much to bear. At that point you take steps to either remove the cause of pain or decrease the pain sensations by taking medications or putting hot or cold on the area that’s painful.
At what pain level should you go to the hospital? ›
Any sudden and severe pain is a signal to head to the ER. Sudden and severe pain anywhere in the body is a signal to head to the emergency room. Of most concern is any pain in the abdominal area or starting halfway down the back.
Is labor pain the worst pain? ›
BACKGROUND: Labor pain is one of the most severe pains which has ever evaluated and its fear is one of the reasons women wouldn’t go for natural delivery. Considering different factors which affect experiencing pain, this study aimed to explain women’s experiences of pain during childbirth.
Why do doctors ask you to rate your pain? ›
The Purpose of Pain Scales
Most scales make pain measurable and can tell providers whether your pain is mild, moderate, or severe. They can also set baselines and trends for your pain, making it easier to find appropriate treatments.
Can a blood test detect pain? ›
Answer: There are no specific blood tests that determine the level of pain you’re experiencing. There are certain blood tests that may be required to determine whether specific medical conditions, for example, Lyme disease, or rheumatoid arthritis, or diabetes, are causing or contributing to your painful condition.
What are signs of extreme pain? ›
For one thing, he notes, severe pain – whether acute or chronic – causes stress on the whole body that can become life threatening. This can be easily measured by increased pulse rate, elevated blood pressure, and dilated pupil size. The patient may perspire heavily, and hands and/or feet can be cold to the touch.
What can I do for extreme pain? ›
- Get some gentle exercise. …
- Breathe right to ease pain. …
- Read books and leaflets on pain. …
- Counselling can help with pain. …
- Distract yourself. …
- Share your story about pain. …
- The sleep cure for pain. …
- Take a course.
How long is too long for pain? ›
Some doctors consider pain to be chronic after three to six months, but others disagree. The normal length of time that it takes for pain to resolve depends on factors such as the type of injury or original source of the pain and what type of underlying process is responsible for it.
What pain scale is chronic pain? ›
GCPS-R scoring:
Persons with chronic pain are placed at Grades 1, 2 or 3. Among persons with chronic pain, those who report that pain limits their life activities or work on most days or every day in the past 3 months (Item 2) are placed at Grade 3 (High impact chronic pain).
Is there a universal pain scale? ›
The Universal Pain Assessment Tool (UPAT) was used to assess the level of pain in people with limited communication skills. The UPAT enables clinicians to consult a specialized pain management team more often and lead to earlier interventions.
How can I test my pain tolerance? ›
It involves submerging your hand into a bucket of ice-cold water. You’ll tell whoever is administering the test when you start to feel pain. Your pain threshold is determined by the amount of time between the start of the test and your first report of pain. Once the pain becomes unbearable, you can remove your hand.
How severe is the pain on a scale of 0 to 10, with zero being no pain and 10 being the worst pain ever? Does it interfere with activities? How bad is it at its worst? Does it force you to sit down, lie down, slow down?
How do you show pain? › Behavioural and autonomic signs of pain
- frowning, sad or frightened face.
- grimacing, wincing, eye tightening or closing.
- distorted facial expressions – brow raising/lowering, cheek raising, nose wrinkling, lip corner pulling.
- rapid blinking.
What happens if you experience too much pain? ›
Chronic pain can interfere with your daily activities, such as working, having a social life and taking care of yourself or others. It can lead to depression, anxiety and trouble sleeping, which can make your pain worse. This response creates a cycle that’s difficult to break.
Does pain make you sleep more? ›
Feeling Pain Makes it Harder to Sleep
Psychologists have found that the more one fixates on sleep, the harder it becomes as well, which could further contribute to insomnia. Once you do fall asleep, acute and chronic pain can also disrupt rest throughout the night, according to some studies.
What pain scale do nurses use? ›
Asking a patient to rate the severity of their pain on a scale from 0 to 10, with “0” being no pain and “10” being the worst pain imaginable is a common question used to screen patients for pain.
What are the 3 different types of scales that are used to assess pain? ›
- Numerical Rating Scale (NRS)
- Visual Analog Scale (VAS)
- Defense and Veterans Pain Rating Scale (DVPRS)
- Adult Non-Verbal Pain Scale (NVPS)
- Pain Assessment in Advanced Dementia Scale (PAINAD)
- Behavioral Pain Scale (BPS)
- Critical-Care Observation Tool (CPOT)
What is the universal pain scale? ›
The Universal Pain Assessment Tool (UPAT) was used to assess the level of pain in people with limited communication skills. The UPAT enables clinicians to consult a specialized pain management team more often and lead to earlier interventions.
What are the 4 types of scales and discuss each type? ›
Psychologist Stanley Stevens developed the four common scales of measurement: nominal, ordinal, interval and ratio. Each scale of measurement has properties that determine how to properly analyse the data. The properties evaluated are identity, magnitude, equal intervals and a minimum value of zero.
What is a 5 on the pain scale? ›
Here, 0 means you have no pain; one to three means mild pain; four to seven is considered moderate pain; eight and above is severe pain. Pain scales are based on self-reported data — that means from you, the patient — so they are admittedly subjective.
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