Rating your pain

Everytime I go to PT and to a new doc they always ask me to rate my pain. MY PT gave me that picture scale of the smiley faces. Well my body just wants to do nothing and just sleep and veg, unfortuantely i don'te have the time or money to give in to my pain.

So my boss and others sometimes don't take me seriously when i say I am in tremendous pain.

Sometimes i doubt myself too. I feel like maybe I'm just making it up when i say I am at 7 because sometimes i'll get one of those shooting pains at 9 or 10 and want to just cut off my arms and hands.

The reason i say 7 is because despite the fact that I can do my daily activies, my body is left in pain at the end of each night and it takes a tremendous amount of faith and love for my faimly to keep moving each day.

I would take more pain meds, but i can barely tolerate the naproxen. i can't be groggy or slightly foggy because I have a young child and need to drive a lot for work.

So am i crazy to say that my pain is like 7 almost every day. As i'm writing right now, my fingers are killing me, but i don't want to give into this stuff, i want to find out a solution.

Rachael I don't put much stock in the pain scales personally. Every person perceives pain in varying degrees. Prime example is child birth. Some women do fine natural while others are disoriented with pain in the 1st stage.

I've seen folks with severed limbs laughing and talking and others out of their mind with the pain. My 5 may be your 8. Some 6s bring tears and others 9s don't.

So even though the scales were created to have a sort of universal code to use in documenting pain or its intensity or lack of its solely to soothe the powers that be. When pain meds are utilized those folks want proof they're working or not and how much or how little.

Medical professionals still view pain as subjective and still document in detail what they see to support your numbers or dispute them.

Physical signs as well as psychological ones. Are you dressed appropriately,is your appearance neat? Crying, irritable, short of breath, quiet or screaming, moaning. Fidgety, pacing,rocking, trembling anything that is used as a distraction. Many chew their lip. Wring their hands.

Nauseous is almost always seen in extreme pain. Sweating is another one. Shallow breathing and head nodding versus talking. Things like increased blood pressure and increased heart rate are signs that show and the patient has no control over but not everyone in pain displays with them.

Pain has always been a difficult thing for Drs and nurse's since it really is almost all subjective in nature. It use to be a rule that medical staff always took complaints of pain seriously as it was thought it was better to inadvertently mis-treat 5 drug seekers then to not treat 1 person suffering.

Sadly this isn't the case anymore and far too many patients in pain get under-treated or not treated.


None of us like being on narcotics for long-term but when our lives are looked at by measuring quality we quickly resign to the idea. Its finding all the right things tied in together that brings that pain number on the scale to the best most consistent we can get.

We are realistic in accepting that zero will not ever be an option for CPers.

Rachel you have been given some good info on ways to get your pain level down. You have not ever mentioned whether you have a pinched nerve or not. If you do have a pinched nerve, you may want to talk to your dr about trying you in on one of the meds used to treat nerve pain, Traditional pain medications have little effect on nerve pain.

Those papers are just worthless in my opinion to rate pain. My pain mgt dr does not use those to rate her patients pain as she feels they are worthless too. She has her own pain scale that she uses and on it she takes into consideration daily activities with or without pain medication and many of activities. Her scale is more real to life. Anyone can say they have pain. She says if a when a patient says their pain is a 10 they should be in a hospital not in her office, lol.

Everyone is so different in how they perceive pain, or what makes it worse or better. Pain is such an individual thing and should be treated that way. It is not a one size fits all type of thing. I hope you will talk to your dr about your pain level because there are meds available that will not make you woozy or unable to drive or care for your child............Susie

I will say after 25+ years of working hospital departments from Ortho/Neuro,ER,Labor hall and ICU that the general consensus in the profession and from my own personal view a person with the highest score of 10 isn't running screaming crying,moaning from the pain they are quiet and serenly calm. There is almost a eerie quality to the air around them. Its so profound, the "look" of pain on their faces. Its like their very eyes hold the depth of that pain. They're somehow begging without words for you to do something.

Its not anything you can ever imagine and the reason I can honestly say I've experienced a 10 only 1 time in my life after being ejected from a MVA.

The majority of Drs don't believe Chronic pain to include 10s on the scale since chronic is a consistent and constant state and your mind couldn't handle much of those kinds of levels of pain for as long as we do

The Drs I worked with believed acute pain reached levels of 10 and chronic stayed steady at 6-8 and we could drop below 6 using what meds and modalities we had designed for ourselves. It always proved true for me personally.

If you look at the state of proven 10s its easily understood how they arrived at that. Child birth,kidney stone,heart attack,aneurism,ruptured spleen broken rib with lung collapse. So no my CP has luckily never brought me levels of 10 although I've been there a time or two with a few of the listed.

I have always found the standard 1-10 pain scale chart a bit lacking, because as been stated, it is so subjective, and people have very different thresholds of pains. And since there are different types of pain, even how one tolerates one type of pain may be vastly different to another person. But I guess they have to use the Pain Chart at least as some form of standard reference.

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Rachel,

it can also be argued, that if you leave severe pain untreated, that you are putting your body through major stress, and that untreated pain can retard healing (i.e. post surgery). It's a trade off sometimes, and depends how bad your pain is, and how well you can or can't tolerate it, and how its affecting your daily life. If you have something physical, that can be fixed (i.e. with surgery), then there is no need to suffer in extra pain while you are waiting to have surgery, imo.

david