A pain scale is a tool used by healthcare professionals to help assess a patient’s pain. This is a self-reporting question that brings up some interesting issues. The first is one of relativity. One person’s 3 could be another person’s 7. There is also the risk of a patient over or under rating their pain so healthcare professionals have to both listen and interpret. In this era of opioid crisis, perhaps it is time to reevaluate the pain scale so that the risk of over-prescribing medication can be mitigated.
Different kinds of pain scales
Numeric rating scales (NRS)
The most commonly used pain scale. Most people are familiar with this one. A zero means ‘no pain’ and 10 means ‘worst possible’ pain.
Visual analog scale (VAS)
This pain scaled shows a line with anchors at both ends. The patient marks a line or X on the line to illustrate their pain intensity. The line can then be measured and compared on the NRS scale.
Verbal pain scale:
- No pain
- Mild pain
- Moderate pain
- Severe pain
- Very severe pain
- Worst possible pain
This scale is most commonly used for children. There are generally 6 smiley faces with simple line expressions indicating:
- Hurts a little
- Hurts a little more
- Hurts even more
- Hurts a whole lot
- Hurts worst
Multidimensional tools for Pain assessment
McGill pain questionnaire (MPQ)
The patient fills out a questionnaire form and pain is assessed based on the key words used to describe pain.
Brief pain inventory (BPI)
Another questionnaire form that includes a series of questions about pain levels over the previous 24 hours.
- Initial pain assessment tool
A paper diagram of the body where patients can mark the location of their pain. There is also a scale to rate pain intensity and a space for comments.
New Visual Pain Scale Proposal
This scale uses masterpiece paintings to illustrate a patient’s pain. It was recently shared on social media (Facebook) and is credited to Patrice Pounders Smith. With the advent and overwhelming success of apps like Instagram, Snapchat and Facebook, our culture has become incredibly visually responsive. Relating to and choosing an image might be an effective tool to add to a healthcare professional’s toolkit.
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