15 Pain Scales (And How To Find The Best Pain Scale For You)

What Is a Pain Scale?

A pain scale is simply a way of rating or quantifying your pain so you can talk about it with your doctor, other health care professionals, or even your friends and family. There are many different kinds of pain scales, but a common one is a numerical scale from 0 to 10. Here, 0 means you have no pain; one to three means mild pain; four to seven is considered moderate pain; eight and above is severe pain.

Pain scales are based on self-reported data — that means from you, the patient — so they are admittedly subjective. Your version of a seven could be someone else’s idea of a three. But the idea is that they can help compare your own ratings over time. Is your pain improving or getting worse? Using a pain scale can also help you and your doctor analyze which factors — a change in physical activity, say, or a new medication regimen — could be responsible for those changes.

5. McGill pain scale

If you suffer from CRPS, the McGill Pain Index may provide a better way to track and explain your pain. Instead of fixing pain intensity only to a number, it compares it to other injuries or types of pain to help quantify it. It incorporate sensory qualities, affective qualities of pain, and evaluative issues to help pinpoint the intensity of pain. The Index, first created in 1971, continues to be a very valuable, reliable, and useful way to measure pain and it’s the leading CRPS pain scale.

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Back Pain Functional Scale [ edit

The Back Pain Functional Scale (BPFS) is a subjective scale used to measure the patient’s physical function after low back pain. This scale was developed by Stratford et al. (2000). It is simple and easy to understand and administer by the patients. This scale is based upon the International Classification of Function (ICF) model proposed by the World Health Organisation. It is used to evaluate the patient’s level of physical independence during the initial two weeks of low back pain. However, it is not used for backpain after two weeks. This scale consists of a total score of 60. Moreover, the patient’s score can be measured from the responses obtained on the Likert scale (0 to 5), and accordingly, a total score is summed up out of 60. Furthermore, the maximum score obtained indicates the maximum physical abilities of the patients. In addition, this scale also has an ‘Adjusted score’ ranging from 0 (0%)-unable to perform any activity to 60 (100%)-no difficulty in any activity[4].

Scale of Pain Bloechle et al

Pain scale of Bloechle et al. (Bloechle C., Izbicki JR et al., 1995)

The scale was developed to assess the intensity of pain in patients with chronic pancreatitis. It includes four criteria:

  1. Frequency of bouts of pain.
  2. Intensity of pain (pain rating on the VAS scale from 0 to 100).
  3. The need for analgesics for pain relief (the maximum degree of expression is the need for morphine).
  4. Lack of efficiency.

NB !: The scale does not include such characteristics as the duration of the attack of pain.

Symptom

Characteristic

Evaluation

Frequency of bouts of pain

No

Several times during the year (2-12 times / year)

25

Several times a month (24-50 times / year)

50

Several times a week (100-200 times a year)

75

Daily (more than 300 times / year)

100

Intensity of pain

No

The Unbearable

100

Symptom

Characteristic

Evaluation

Need for analgesics for pain relief

No

Aspirin

1

Tramadol

15

Buprenorphine

80

Morphine

100

Duration of disability during the past year, due to pain

No

1-7 days

25

Up to 1 month

50

Up to 365 days a year

75

Constantly

100

If more than one analgesic is used, the need for analgesics for pain relief is equated to 100 (maximum score).

In the presence of continuous pain, it is also estimated at 100 points.

Score is made by summing up estimates for all four characteristics. The pain index is calculated by the formula:

Overall assessment by scale / 4.

The minimum score on the scale is 0, and the maximum score is 100 points.

The higher the score, the more intense the pain and its impact on the patient.

14. Personalized scale

Even though this scale is similar to many of the others on this list, we thought it was important to show that yes, you can and should create a scale for pain that works for you. It doesn’t have to be fancy. This pain inventory helped this patient accurately track their pain according to how they were feeling and how their pain affected them.

This same patient then used a daily tracker to mon

This same patient then used a daily tracker to monitor her pain levels. You can see a great example of that in the image below. For visual people, this is a fantastic way to quickly understand and see pain changes over time.

For help with these practices: WellBeing Alignment Sessions

If you would like help in bringing your emotional pain into awareness for healing, I invite you to a WellBeing Alignment Session. During your session, the places of constriction that are most ready to heal are invited to show themselves.

Together, as awareness, we will allow the emotional pain within you to be seen as it is, within a field of love and openness, allowing them to unwind naturally.

You’ll learn ways to continue the healing process on your own.

Wong-Baker Faces Pain Scale

NIH / Warren Grant Magnusen Clinical Center

The Wong-Baker FACES Pain Scale combines pictures and numbers for pain ratings. It can be used in children over the age of 3 and in adults.

Six faces depict different expressions, ranging from happy to extremely upset. Each is assigned a numerical rating between 0 (smiling) and 10 (crying).

If you have pain, you can point to the picture that best represents the degree and intensity of your pain. 

Impact

Psychological pain can also contribute to or worsen physical pain in different areas of the body. Some common types of physical pain that may be connected to emotional distress include:

  • Diarrhea
  • Dizziness
  • Headaches
  • Muscle pain, particularly in the neck
  • Nausea
  • Pain in the arms and legs
  • Stomachache or gastrointestinal upset

Emotional pain can also be accompanied by:

  • Aggression and violence
  • Alcohol or substance use
  • Attempted suicide
  • Compulsive behaviors including shopping, gambling, and sex addiction
  • Eating disorders
  • Risky behaviors
  • Self-harm
  • Suicidal thoughts

Such behaviors are often an attempt to diffuse or escape the intense dysphoria caused by emotional pain.

Physical vs. Emotional Pain

While physical pain and emotional pain are different, there is research that suggests that both types of pain may share some neurological similarities. Both emotional and physical pain are linked to changes in the prefrontal cortex and cingulate cortex.

Some researchers argue that rather than viewing emotional pain and physical pain as fundamentally different, they should be conceptualized as both being part of a broader pain continuum. Some types of pain are purely physical while others are purely emotional; but many times, pain lies somewhere in the middle.

CRIES Scale

NIH / Warren Grant Magnusen Clinical Center

CRIES assesses crying, oxygenation, vital signs, facial expression, and sleeplessness. It is often used for infants 6 months old and younger. It's widely used in the neonatal intensive care (NICU) setting.

This assessment tool is based on observations and objective measurements. It is rated by a healthcare professional, such as a nurse or physician.

Two points are assigned to each parameter. A rating of 0 means there are no signs of pain. A rating of 2 means there are signs of extreme pain.

Visual analog scale (VASH)

Visual Analogue Scale (VAS) (Huskisson, E. S., 1974)

This method of subjective assessment of pain is that the patient is asked to mark a point on the non-graded line, 10 cm long, which corresponds to the degree of pain. The left border of the line corresponds to the definition of “no pain”, the right line – “the worst pain you can imagine.” Typically, a paper, cardboard or plastic ruler with a length of 10 cm is used.

On the back of the line, centimeter divisions are marked, according to which the doctor (and in foreign clinics this is the responsibility of the average medical staff) marks the value obtained and enters it on the observation sheet. The absolute advantages of this scale include its simplicity and convenience.

Also, in order to assess the intensity of pain, a modified visual analogue scale can also be used, in which the intensity of pain is also determined by different shades of colors.

The disadvantage of VAS is its one-dimensionality, that is, on this scale the patient only notes the intensity of pain. The emotional component of the pain syndrome introduces significant errors in the VAS indicator.

With dynamic assessment, the change in pain intensity is considered objective and significant if the current value of the VAS differs from the previous one by more than 13 mm.

Consciously opening to a larger energy field

…and then the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.~ Anais Nin

When untruth is consciously met by truth within you, your energy field begins to vibrate at a higher frequency of love and wellbeing.

This is very much like the metaphor of “thinking outside the box.”

If you think of a problem as being contained within a box, you can’t solve the problem by only looking within the box. You need to expand out beyond the box of the problem to find the solution.

In the same way, we need to shift our attention and point of reference beyond the limited energy field of our wounds in order to notice that we are the consciousness the wounds (as well as our entire lives) is arising IN.

This consciousness we are is the only place of peace. As we turn attention toward the truth of our being, gradually suffering unwinds on its own because we are no longer identified with it. The old wounds and emotional pain are no longer fed energy by our identification with them and then, starved of energy, they begin to fall away. 

Supplementary Information

Additional file 1: Supplemental Table 1 Exploratory Factor Analysis Solutions Validating the OMMP. Supplemental Table 2 Cronbach’s Alpha Across Samples. Supplemental Table 3 Correlations Between First-Order Latent Variables OMMP. Supplemental Table 4 Initial Exploratory Factor Analysis OMMP. Supplemental Table 5 Parallel Analysis Raw Data Eigenvalues, Means and Percentile Random Data Eigenvalues. Supplemental Table 6 Refined OMMP-9 Exploratory Factor Analysis. Supplemental Table 7 Goodness-of-fit Indices for Measurement Invariance Analyses Across Mental Health Diagnoses OMMP-8. Supplemental Table 8 Goodness-of-fit Indices for Measurement Invariance Analyses Across Sex OMMP-8. Supplemental Table 9 Goodness-of-fit Indices for Measurement Invariance Analyses Across Injury Status. Supplemental Table 10 Goodness-of-fit Indices for Measurement Invariance Analyses Across Age Groups. Supplemental Table 11 Goodness-of-fit Indices for Measurement Invariance Analyses Across Activity Level. Supplemental Table 12 Goodness-of-fit Indices for Measurement Invariance Analyses Across Athletic Classification. Supplemental Figure 1 Covariance Model OMMP-9.

Psychometric properties of Back Pain Functional Scale (BPFS) [ edit

According to Stratford et al. (2000), this scale has a minimal detectable change of 22.2% with a standard error of measure of 6.5% at a 95% confidence interval. In addition, this scale has excellent test-retest reliability with an intra-class correlation coefficient of 0.88 at a confidence interval of 77%. Thus, this representation indicates that this scale can be used in the clinical setting to measure the functional outcome of patients after low back pain[4].

However, there are other functional scales used to measure physical function in patients with low back pain besides back pain functional scale. These are ‘Roland-Morris disability scale’, ‘Oswestry disability scale’, and ‘Short form 36 surveys’. Therefore, it is necessary to consider the relative efficacy and effectiveness of ‘Back Pain Functional Scale’ as compared to other scales.

Conclusions

The original scale structure of the OMMP was not supported in our study. We subsequently identified a refined 3-factor, 8-item OMMP (i.e., OMMP-8) that met contemporary recommendations for model fit and multi-group invariance testing. Our findings support the OMMP-8 as a more viable option to assess PsyPn in research and clinical practice, but caution is warranted until more research is completed to further assess the measurement properties of the refined scale.

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