Pain Scale Reformation

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
Emogi scale

This scale is most commonly used for children. There are generally 6 smiley faces with simple line expressions indicating:

No pain

  • 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.

NHS Solutions is an industry leading specialty interim staffing firm. We work alongside highly qualified interim nurse leaders who are addressing issues such as pain management. Our deep pool of interim leadership candidates is available to quickly fill crucial leadership gaps for our clients. NHS Solutions is able to present experienced clinical and allied interim leaders to a hospital within 24 hours in most cases. Reach out and ask today about your next career move or how we can assist in filling your next leadership gap.


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