I used to think the pain scale was subjective and useless *until I found a tool* that explained what each number meant and used it in my daily practice. When I pull it out, I make sure to explain to my patients that “I’m in no way trying to minimize your pain, I’m just trying to make sure when you say your pain is an 8 (6,4,etc), we’re all on the same page what your pain level describes your pain to be” I then read off from the following chart I keep in my smartphone:
# Symptoms Medications
1 Very minor annoyance. Occasional minor twinges.
No medications needed
2 Minor annoyance. Occasional minor twinges. No medications needed.
3 Annoying enough to be distracting.
No medications needed.
4 Can be ignored if busy, but is still distracting.
Mild painkillers are effective (Motrin/Tylenol)
5 Can’t be ignored for more than 30 minutes.
Mild painkillers relieve pain for 3-4 hours. (Motrin/Tylenol)
6 Can’t be ignored for any length of time, but you can still work/do social activities. Stronger painkillers reduce pain for 3-4 hours. (Vicodin/Codeine)
7 Makes it difficult to concentrate. Interferes with sleep. You can function with effort. Stronger painkillers are only partially effective. (Vicodin/Codeine)
8 Physical activity is severely limited. You can read and converse with effort. Nausea and dizziness.
Stronger painkillers only minimally effective (Vicodin/Codeine)
9 Unable to speak. Crying out or moaning uncontrollably.
Strongest painkillers are only partially effective (Oxycontin / Morphine)
10 Either you are unconscious or it makes you want to pass out.
Strongest painkillers are only partially effective. (Oxycontin / Morphine)
When I read the description and the medication listing for the number the patient gives me and the medication description required to alleviate that pain, I then say “Does this sound like this is the number that best describes your pain?” I’d say 70% of the time the patient says “Of, I guess my pain is a lower number than that…” I read the two numbers below and *let them decide* what number best describes their pain, and I keep going until I reach a number that they say is appropriate for them.
I tell them -again- that we’re not trying to minimize their pain level, but since one person’s #8 and another person’s #8 may be completely different, in this manner we all know what a #8 on the pain scale means and we can treat everyone appropriately. They seem to really appreciate this and understand that I’m trying to understand exactly *what level of pain relief they need*.
I hope this helps you. Of course… you’ll still have someone who refuses to listen or states their pain is an 11 or 25. Those can’t be helped or won’t listen. But those others can be EDUCATED about the pain scale and I feel at least I’ve done the next nurse a great service – even if that next nurse is me 🙂