Pain Scale

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

Can you relate?

i'm calling bs as the pain rating. it is so subjective individually.

i think as chronic pain suffers as migraineurs, our sense of perception of pain is low compared to the general public (that means we judge pain lower vs. the general healthy public).

i think a 10 is a crushing injury. i think injury to different parts of the body rank differently--thus the Wong-Faces (sorry, or whatever it is called) is misleading. i've come to the conclusion that rarely in medicine that people feel migraine is a genuine 9 or 10.

i'll dare to compare that crushing a thumb in a car door on the nail is worse than the worst migraine i've had. and any of you guys on the forum for the last several years know i've had some pain here and there. i'll rate my thumb as a true 10. extreme pain, passing out pain. i've had horrible migraine, enough to draw a tear here or there. it's a different pain.

the pain scale is so subjective, that migraine i think requires its own. you can swallow razor blades, and it won't compare to migraine. i've had enough invasive procedures that i can call cutting muscle or damage to nerves different than migraine.

again, keep in mind each is different. from the time spent in ERs and hospitals, a 10 for a migraine or even surgical pain doesn't gather the support of a "7" unless you're really obvious in horrid pain. and in most circumstances it's up to a nurse to determine what you get vs. what gets a phone call to the doc. if your pain is bad.

just my thoughts.

I think the reason the migraine is so much more painful is because it is effecting your head as opposed to another body part. I have had serious injuries to my knees, been in labor, etc... And while painful, because the pain is localized elsewhere on the body, it is not as intense or debilitating as it is in my head. The other problem with it being in the head is that it makes most cognitive functioning really difficult. So even smaller headaches (4-6) on the pain scale really mess up your ability to do simple tasks, make basic decisions, prioritize, etc... The same level of pain in your arm or your foot would be annoying and unpleasant, but not as disruptive. But I do like the picture of the 11 rating

Ha ha...love it!

It is so subjective, but I've never had a migraine, in my eyes, that rated a 9 or 10. I've had two situations that I consider a 9. One my ovary was being strangled by my fallopian tube...ambulance ride, emergency surgery. But, even though I couldn't speak, or stand up straight, I was still ambulatory.

And recently with the diverticiultis. Again, I couldn't speak, was doubled over, but was still ambulatory.

In my interpretation of pain scales, if I can still walk, I'm not at a 10.

I think the highest I've ever rated a migraine was an 8. But, that's based on my personal interpretation (and living with a Mom who was a nurse).

Hi,

The second pain scale is certainly more realistic than the first. I love the pictures.

I have found the pain scale to be quite subjective- some people can walk around with a 7 and others can't.

Here is my personal pain scale

1. No Pain

2. Hurts a little bit, but will go away quickly- maybe a paper cut or skinned knee.

3. Hurts more, but will go away without medication or with a bandaid.

4. Pain begins to interfere a bit, but quickly resolves with aspirin or tylenol.

5. Pain really starts to interfere with life, but I can push through it with medicaion

6. Pain interferes with life, medication such as tylenol takes the edge off, but I can still function. I may have to rest for a bit at this point.

7. Pretty severe pain. Usually requires some medication- Tylenol 3 and rest. I can get some things done.

8. Pain is severe. It is impossible to concentrate for any period of time. Medicine takes the edge off, but that is it. I find it hard to function.

9. It is impossible to function due to pain. All I want to do is curl up in a ball and wait till it goes away. Medicine helps, but npot much. Will usually require steroids or an IV to break the headache.

9.5- the window looks good

10. Screaming and the window looks really good.

The sad thing is that my pain hasn't gone below a seven in years and usually hovers in the 7-9 range. It hits 9.5 every few weeks.

Pain free days,
sailing

Love it!! I think the second group of pictures should be the official one! I've often joked with my husband over this while staring at the pain rating scale on the wall.

I agree, pain perception is very subjective.

It also depends on our state of mind, at ceratin times it is easier to bear a really bad pain, at others even low level of pain can serious interfere with your life, when you are tired and feeling down etc, we feel pain differently.

I hate that "what scale pain" the doctors are keen to ask - I always say lower then it is, I don't know why I do that.

It is subjective. It varies from person to person. It needs to be assessed in person. One's body language, posture, rate of movement, and general presentation help determine their "number".

Tone of voice, volume of voice, rate of speech, etc all help support a number, too.

If I have a 9 I am going to be in loose fitting clothing, not have my hair in a ponytail or headband, be a little hunched over, be shielding my eyes from lights, be speaking in a slow and soft voice, and will be moving slowly and stepping lightly (as even walking hurts). I will be confined to a bed or couch, I will not be able to perform any duties including posting on the internet, and my only concern is going to be having an ice pack on my head.

I have only entertained calling my head pain a 10 once, and that did prompt a visit to the ER.

I have had a pain of 10 from post-surgical pain once. It was awful. I was not able to roll over let alone walk. It was abdominal pain following a hysterectomy. Heavy duty drugs were required.

The 10 from the head pain and the 10 from the surgery pain were completely different. I could still walk around with the head pain but of course my motions were slower.

People who claim to have a 10 from head pain should be incapacitated, confined to bed or a couch.

My neuro uses a 0-3 head pain scale.

0- no pain

1- a little pain, not requiring medicine, not disrupting activities

2- moderate pain, requiring meds, disrupting but not preventing activities

3- severe pain, normal activity is impossible

My days are either a 1 or a 2, with a few hours of a 3 a few times a month. This is thanks to the shunt and the long-acting opiods and the combo of nortriptyline and topamax. This entire combo has finally given me a new lease on life. We are going to add Botox in January to see if we can wipe out those 3s.

Az

I really like your neuros idea of a different pain scale for m's.

I think I'd add a 4 though for when not only are you unable to do normal activity, you can't even fathom it. The ones that bring me literally to my knees, sobbing. That doesn't happen very often, I try my darndest not to cry, as it only makes the M worse. But, sometimes the self control deserts me, and that's when I would be a 4 ( a 10 in dog years...oops, no, a 10 in the normal world).

Yes, I agree as well pain is subjective.

migraines

endometriosis

chronic sinus infections

acute renal failure and sepsis

14 different surgeries from eyes to my knee and everything in between.

Etc..too many to list

Cheryl,

I LOVE her blog. She is absolutely hilarious and so clever! Thanks for posting. Did you read the one about her dogs? It kills me and reminds me of my crazy dog

The pain scale is by definition subjective. There is no way that two people experience pain the same way. Her scale is much more realistic I think I will print it out and take it to my next pain Dr. appt!

Mary Anne

MaryAnneLive wrote:Cheryl,

I LOVE her blog. She is absolutely hilarious and so clever! Thanks for posting. Did you read the one about her dogs? It kills me and reminds me of my crazy dog

The pain scale is by definition subjective. There is no way that two people experience pain the same way. Her scale is much more realistic I think I will print it out and take it to my next pain Dr. appt!

Mary Anne

The dog having to move one had me in tears. "Made food, I'm magical!" too funny. I'm a big fan of hers. I printed the pain scale too and have it posted in my office. I can relate better to that one. If the average person suddenly felt what we feel, they would think they were dying.

Before I found any pain scales to use as a reference I made up my own which relates more to ability/disability.

I've used this in my headache diaries ever since and all the neuros I have seen have understood it and said to keep using it.

1. Not too intrusive.
2. Can do most things if I am careful.
3. Can do the basics but no more. Am unable to concentrate.
4. Unable to function.
5. Can't even move about.

AZgirl said:

My neuro uses a 0-3 head pain scale.
0- no pain
1- a little pain, not requiring medicine, not disrupting activities
2- moderate pain, requiring meds, disrupting but not preventing activities
3- severe pain, normal activity is impossible

I like this pain scale for headaches. I might add some half way points in between the each of the steps.

My days are mostly 1s with days, which I would call it a 1.5, where I can tough it out with out meds. I have at least a couple of 2s at least every 7 to 10 days. And every once in a while, I get a a 3, then the Midrin kicks it down to a 2. Those 3s, I get at night, which we all call pillow headaches.

I keep it down to those levels by going to acupuncture or trigger point massage therapy at least three or four times a month and daily somatic exercises (about 45 minutes in the morning and 30 minutes at night) to keep the muscles from getting tight.

Martin

Interesting pain scale!! Wish they had something like that when you fill in those wad's of paperwork each time you see a different specialists and they ask you to rate your pain! I have a 2-3 most days and up to a 6 probably 3 times a month. I've had 8's before although I'm grateful they are not as often anymore. Exercise definately helps. I also have regular acupuncture 5-6 times a month and for about 12hrs after treatment I have a 1 which is awesome. I have experienced a few days of 0 in the last 9 months which was totally out of this world!

Martin, you mentioned trigger point massage therapy. I haven't heard of that before - I've had swedish massage. Is that as explanatory as the name - massage on the trigger points?

lissy asked:

Martin, you mentioned trigger point massage therapy. I haven't heard of that before - I've had swedish massage. Is that as explanatory as the name - massage on the trigger points?

The correct name is neuromuscular therapy, their school of thought is that over the years, the body's muscular systems compensates for the injuries and bad posture throwing your body out of balance. Therefore, while your shoulder and neck might hurt, the muscles in your pelvis area might be out of balance throwing your gait out of balance, causing you to walk with a slight twist. Then, you compensate by twisting your upper torso and shoulders. Then you neck is twisted causing pain. The therapist works by removing the trigger points in your pelvis area, then your torso, shoulder, and then your neck.

Somatic practitioners do the same, but with little if any pain. They believe that if the session is painful, the muscles will again contract causing your pain. The most improvement, that I've had for my shoulder has been with the Somatic practitioner. What I like about this method, is that they give you specific exercises to cover the muscles that they worked on during the session.

The Feldenkrais and Anat Baniel Method practitioner, both do the same. Somatic and Anat Baniel are both derived from Feldenkrais and have exercises that work on your muscles to keep them from contracting.

Martin

Thanks Martin, that sounds really interesting. I will have to look around and see if anyone locally practices that technique as its worth a try.

I agree that migraines should have a different pain scale. I have had worse pain than a migraine but would rather have that than the migraine. I can function with severe pain of other parts of the body but am worthless with a migraine.