Exhausted and frustrated by this question at each checkup, our chronic pain community has gotten together and is requesting a better pain rating system. For many different reasons, the overwhelming consensus seems to be that the current one -- gauging your pain at one point in time on a scale of one to ten -- is just too simplistic.

Here are snippets from the discussion - very insightful:

The pain isn’t better but your body has adjusted to it

  • Virg: “…your body "adjusts" to the pain and something that a month ago you might have rated a 7 becomes a 4 (which) that stupid pain scale doesn't take into account. That doesn't mean that the pain is getting easier to deal with - generally it means that overall it is escalating and now you have even more intense pain that your body is learning to deal with so that you can still try to function.”
  • Erin: “Yup, yup, yup.....exactly. I really hate when I say I am still in as much pain but tolerating it better. Then I get the great ‘so you are doing better!’ Ummmm noooooo I did not say that. So I stopped saying that. Now I go in and say it is the same. Cause it is! I just am doing more since I figure I will hurt no matter what!”

The frownie faces are just silly

  • Don: “That freaking pain scale, why and who came up with this dumb thing, …I worked out a thing with my pain dr’s office. I’ve been with him 8 mths now so we both know what I hurt like most of the time so when they or he asks me what my pain is, I will either say baseline, or lower than or higher than.”
  • Squirrelypox: “I like your baseline scale idea. Sounds a lot more informative than the arbitrarily chosen "5" (aka the blushing constipated frownie on the visual image scale, if you're ever so lucky as to be asked to use that measure).”

One number doesn't give the full picture

  • Squirrelypox: “What is your pain rating today?” This question makes me want to slam my head into a brick wall…After months of pain shooting down my leg, I've managed to find a few innocuous positions for idle time. Chances are I am standing in one of those positions as they ask me the question. When I answer with a "0," I get asked if I really need to see the doctor today, since I have no real pain. But it doesn't take into account that the moment I move it's going to start up again. It's so arbitrary. I get stabby every time someone asks me this b/c I don't know how I am supposed to answer while giving a full picture of the pain.”

Me: Hopefully, voicing the above frustrations will help with the clinician-patient communications. To all chronic pain patients and clinicians out there, what do you use that works better than the 1 – 10 pain scale?

More reading:

How is your pain rating today – full discussion