There’s some attempt to try and make it genuine, and there are guidelines around it to support that (e.g. 1 = barely noticeable, 3,4 = distracting, 5,6 = unignorable, 7,8 = prevents normal activities, 9 = prevents conversation)
But in practice you’re going to get about one in every dozen patients who engages with this scale in good faith and you’re going to get a number between 8-11 from everyone else.
The absolute nature of the scale isn’t THAT important, yeah it gives you an idea of how the pain feels, but what’s more important is how the number changes over time.
If a patient keeps saying “IT’S AN 11!!” for an hour and then now it’s a 9? Great, we’re moving in the right direction.
If someone starts out saying it’s an 11 and suddenly it’s a 15? Well, what changed? Did some meds wear off? Did they shift and move something that increased the pain?
Heck, 90% of the time if I get there and it’s an 11, then just 10 minutes later it’s suddenly a 6 cause they’ve calmed down now that help is there.
Having just gone through something…I can attest to the fact that when you see no end to the pain, the mental anguish is immense. For some people that means a couple of points.
For me when asked, I always think “could it be worse?” and having never had my balls trampled by a herd of elephants, or been hanged, drawn and quartered…I could never give a 10.
While that’s fair, there does exist pain for which you can’t really imagine much worse at that moment. For me those have been kidney stones and a broken femur.
Try describing the pain using the OPQRST pneumonic.
Onset - what where you doing when it started?
Provocation - does anything make it better or worse
Quality - what type of pain is it. Stabbing, burning, etc.
Radiating - is the pain in one spot, or does it radiate out to other spots.
Severity - what’s the 0-10 pain scale.
Time - How long has this been occuring
The numbers are irrelevant. It’s just an arbitary scale.
If you were experiencing a pain that’s so mild it’s basically just a feeling of discomfort, you’d be able to describe that, right? And you it you were experiencing a pain so intense that it has you literally screaming? You’d be able to describe the difference between them, right? Well there’s literally a conversion chart that translates those feelings into numbers.
You don’t have to conceptualise anything — it’s literally printed on a paper for you when they ask you the question. As long as you can experience pain and either read a description of pain severity, or describe your pain severity to someone who can read, you can use a numerical pain scale.
Maybe this varies from country to country, but IME the mapping of descriptions to numbers isn’t clear, which makes it hard to give a good response. At best, they’ll pull out something like this.
Well yes but you get folks who see that and can imagine worse pain so they say it’s a 9 instead of a 10 or who just can’t really tell what a 5 feels like
Kidney stone is a ten, getting stabbed in the arm is about a 7, broken tailbone at about an 8, stubbed toe at about a 5. Papercut at a 2. Single punch or slap at a 1. Getting branded was about a 3 for like 15 seconds then it dropped down to a 1.
Its all objective of course but thats pretty much my scale
Edit: depression induced phantom pain at an 6, maybe a 7. Kinda feels like what i would imagine a heart attack to feel like
Its a long story lol. Wanted to show off for a woman, happened to mention i have nerve damage and cant feel certain types of pain. Funnily enough, that does not extend to thermal pain but whatevs. She branded me, and then we never saw each other again XD super cool brand though.
Just in case, branding here refers to using a red hot piece of metal to burn an imprint onto skin
There’s some attempt to try and make it genuine, and there are guidelines around it to support that (e.g. 1 = barely noticeable, 3,4 = distracting, 5,6 = unignorable, 7,8 = prevents normal activities, 9 = prevents conversation)
But in practice you’re going to get about one in every dozen patients who engages with this scale in good faith and you’re going to get a number between 8-11 from everyone else.
The absolute nature of the scale isn’t THAT important, yeah it gives you an idea of how the pain feels, but what’s more important is how the number changes over time.
If a patient keeps saying “IT’S AN 11!!” for an hour and then now it’s a 9? Great, we’re moving in the right direction.
If someone starts out saying it’s an 11 and suddenly it’s a 15? Well, what changed? Did some meds wear off? Did they shift and move something that increased the pain?
Heck, 90% of the time if I get there and it’s an 11, then just 10 minutes later it’s suddenly a 6 cause they’ve calmed down now that help is there.
Having just gone through something…I can attest to the fact that when you see no end to the pain, the mental anguish is immense. For some people that means a couple of points.
For me when asked, I always think “could it be worse?” and having never had my balls trampled by a herd of elephants, or been hanged, drawn and quartered…I could never give a 10.
While that’s fair, there does exist pain for which you can’t really imagine much worse at that moment. For me those have been kidney stones and a broken femur.
I’ve never been able to properly conceptualise converting the pain I’m feeling into a 1-10 scale.
It just doesn’t make sense to me
Try describing the pain using the OPQRST pneumonic.
Onset - what where you doing when it started?
Provocation - does anything make it better or worse
Quality - what type of pain is it. Stabbing, burning, etc.
Radiating - is the pain in one spot, or does it radiate out to other spots.
Severity - what’s the 0-10 pain scale.
Time - How long has this been occuring
https://en.wikipedia.org/wiki/OPQRST
As you can see, Severity is just one of the parts of the assessment.
The actual descriptions would work for me. I could tell someone if it’s unignorable or whatever pretty easily over a number.
The numbers are irrelevant. It’s just an arbitary scale.
If you were experiencing a pain that’s so mild it’s basically just a feeling of discomfort, you’d be able to describe that, right? And you it you were experiencing a pain so intense that it has you literally screaming? You’d be able to describe the difference between them, right? Well there’s literally a conversion chart that translates those feelings into numbers.
You don’t have to conceptualise anything — it’s literally printed on a paper for you when they ask you the question. As long as you can experience pain and either read a description of pain severity, or describe your pain severity to someone who can read, you can use a numerical pain scale.
Maybe this varies from country to country, but IME the mapping of descriptions to numbers isn’t clear, which makes it hard to give a good response. At best, they’ll pull out something like this.
Well yes but you get folks who see that and can imagine worse pain so they say it’s a 9 instead of a 10 or who just can’t really tell what a 5 feels like
Kidney stone is a ten, getting stabbed in the arm is about a 7, broken tailbone at about an 8, stubbed toe at about a 5. Papercut at a 2. Single punch or slap at a 1. Getting branded was about a 3 for like 15 seconds then it dropped down to a 1.
Its all objective of course but thats pretty much my scale
Edit: depression induced phantom pain at an 6, maybe a 7. Kinda feels like what i would imagine a heart attack to feel like
Getting branded?
Its a long story lol. Wanted to show off for a woman, happened to mention i have nerve damage and cant feel certain types of pain. Funnily enough, that does not extend to thermal pain but whatevs. She branded me, and then we never saw each other again XD super cool brand though.
Just in case, branding here refers to using a red hot piece of metal to burn an imprint onto skin
Are you, by chance, a cow or horse?