What Is a Pain Scale?

Different Types of Pain Scales

Pain scale
BSIP/UIG/Getty Images

A pain scale helps you rate your level of pain so it can be communicated to your doctor (e.g., rheumatologist), other health professionals, or even your family. It's a self-reported pain level and that makes many patients leery of its "accuracy." Some patients will say "What does a 4 feel like?" or express uncertainty about the whole pain scale concept. It's a somewhat valid point. What I might call 7, you might say is 3.

It's subjective. The value still comes in comparing your ratings. If you rate your pain as 4 this week and next week you rate your pain as 6, that suggests there may be worsening of arthritis symptoms.

There are different types of pain scales -- verbal, numerical, and visual pain scales. Let's see how they are similar and how they are different.

Verbal Rating Scales

Verbal pain scales, as the name suggests, use words to describe pain. Words such as no pain, mild pain, moderate pain, and severe pain are used to describe pain levels. A score from 0 to 3 is assigned to each of those word pairs and is used to measure the pain level.

Numerical Rating Scales

A numerical scale with the range of 0 to 10 is another type of pain scale that is used. "No pain" is associated with "0" and "worst pain possible" is associated with "10." You are asked to choose a number from 0 to 10 that best reflects your level of pain.

Visual Analogue Scales

VAS or visual analogue scales use a vertical or horizontal line with words that convey "no pain" at one end and "worst pain" at the opposite end. You are asked to place a mark along the line that indicates your level of pain.

Wong-Baker FACES Pain Rating Scale

With the Wong-Baker pain scale, six faces are used that are numbered 0 to 5 underneath:

Face 0 is a happy face (no hurt)
Face 1 is still smiling (hurts a little bit)
Face 2 is not smiling or frowning (hurts a little more)
Face 3 is starting to frown (hurts even more)
Face 4 is definitely frowning (hurts a whole lot)
Face 5 is crying although you don't have to cry to choose this face (hurts the worst)

The FACE pain scale would be particularly useful for children with arthritis who may not have verbal skills to otherwise express their pain level.

Bottom Line About Pain Scales

The aforementioned pain scales focus on the severity of your pain, but they really don't delve into any other aspect of pain, such as qualities of pain (sharp, dull, throbbing) or other characteristics of pain (annoying or unbearable). There are questionnaires designed for that purpose. The questionnaires gather more details about your pain than what can be derived from pain scales.

You will find a pain scale in almost every doctor's office. When you are asked to rate your pain, be honest. Don't stress over whether you gave the right answer.

There is no wrong answer. The value of the pain scale is in comparing week to week or doctor visit to doctor visit. Patients need to remember that a pain scale is used for comparative purposes of their own individual condition. It does not compare one person to another.

Sources:

Pain Rating Scales. The University of Texas M.D. Anderson Cancer Center. Patient Education. Accessed 01/06/2016.
https://www4.mdanderson.org/pe/index.cfm?pageName=opendoc&docid=3958

Pain Assessment Tools. Partners Against Pain. Accessed 01/06/2016.
http://www.partnersagainstpain.com/hcp/pain-assessment/tools/

Continue Reading