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Pain Scale Understanding

Hi Everyone!

Just wondering if anyone else gets as frustrated when every appt you go to, one of the first questions they ask is what is your pain on a scale of 1-10.

My first response is always, right now?

Usually when I have an appt, i take the day off work. Its usually an easy morning and I spend my time sitting. So when the question is asked, Im not in that much pain. I think that may be why it has taken so long for me to get to surgery.

When I see the docs, I get to further explain my pain.

Also, I never say my pain is either a 9 or a 10, I think about it like this. A 10 is the worst pain imaginable, so does my back pain ever feel as bad as say, being burned by a torch? well no. How about getting eaten by a shark, that would hurt really bad, right? So I may be going about this pain scale all wrong.

L5S1 REMOVED herniation. Years of pain & compression. Microdiscectomy complete!! Trying to be super smart & safe with recovery!


  • dilaurodilauro ConnecticutPosts: 9,842
    probably should be used as a guideline only. I've never been in favor of the current scale of 1 to 10... Mainly because some folks think if they say 10, they are going to get better treatment or more medications... And those that say 0 or 1 are going to get less treatment and help.

    Also, those levels depend on some many variables. Have you had recent treatment?, When was the last time you had your pain medications, etc

    With the current scale in place, Anyone having a Pain level of 9 or 10 should be heading directly to the ER... At those levels, you basically can not take care of yourself.

    A couple of years ago, I posted my version of a Pain scale:

    I am doing pretty good, some discomfort but overall good

    Not doing all that great, A lot of discomfort, so I need to take it easy

    I am HURTING, I really cant do a lot, I should be lying down or in the ER

    I've used this scale with my Physical Therapist and my Physiatrist for a while now and they completely understand
    how I am doing when I meet with them.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I too get frustrated and I never give a number I ask them what the number would be. When I have to go to the ER I am gritting my teeth, labored shallow breathing, and have a hard time speaking. I refer to this as an 8, The ER marks it down as a 10. Like many of us we are used to the pain, I was born with it and never had a pain free day until I was given 8mg of daluidid ( i am now 47). A 10 for me was during my heart attack where I actually ripped the muscles in my left arm with my right.

    I have seen many charts on it and if I went by those charts my pain is a constant 8. I don't tell anyone this because they find it hard to believe, but when you have to endure it you endure it. So yes I agree describing your pain symptoms is much better as it places the number on the health care professional and it does not make you look like a wuss or someone looking for drugs. Often I will describe them and ask them what the number is, as I stated they mark it down as a 10.

    Also my pain is worst at night, well like you my appointments are in the morning when it is the least. My doc does have evening hours and I was able to get in at 8:30pm tonight. He examined me and saw first hand the pain and me jumping off the table when he hit the herniated disk. I did get the script this time and in sufficient quantities to last 30 days.

    It’s tricky to say the least but I also agree saying it’s a 10 is not good. Also saying a 5-6 is not good as they have told me that is there target so if you say 5-6 they won’t do anything.
    This is just my experience in my area for about 3.5 years now
  • ben_indianabben_indiana Posts: 288
    edited 09/08/2012 - 5:33 PM
    The pain scale caused me to be underestimated. The surgeon told my wife after surgery that the herniation was worse than he expected and was very suprised I was still working & functioning. Flares up a little anger about the first surgeon I saw who wanted to send me to PT! But I am just gonna be happy the 2nd surgeon got that nasty herniation out for me and I can ride this road to recovery!
    L5S1 REMOVED herniation. Years of pain & compression. Microdiscectomy complete!! Trying to be super smart & safe with recovery!
  • tran92ttran92 Posts: 183
    edited 09/09/2012 - 4:21 AM
    I totally agree with you Ben. I would never say my pain is a 10, i figure if its that bad, i'm either passed out of completely useless. But if i say my pain is a contstant 3, then they figure there is nothing to do because its not bad. but if i can get through my day and do what i have to do, all be it, the minimum of what needs to be done, then i don't consider my pain to be at a 6 or a 7. When i conisder myself a 6 or a 7, i'm ready to cry, and have extreme difficulty doing much of anything.

    Unfortunately i've also learned to bump my numbers up a bit when i see a doc. my 1st surgeon was on the verge of cancelling my revision surgery for a herniated l5-s1 because i said my pain levels had gotten much better. they weren't gone, but compared to a month earlier, much better. well, i had about 85% blockage of the spinal canal at that point, so he decided he would do the surgery anyway. but the anxiety i had over waiting for him to make a decision.... not pleasant. and as it turns out, after the surgery, he said i really did need it because of how large the herniation was and where it was sitting.

    its all so frustrating. its too subjective a thing to get a nice set answer. one person says a 3, and another will swear the equivalent is an 8. i wish they could come up with a much better set of descriptions to maybe standardize the thing a bit more. those smiley faces really don't mean much.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
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