Pain Scale and Its Importance

     For over 15 years, and probably longer, the pain scale of 0 to 10 has been both a valuable and mis-leading part of medicine. For those who read my blog regularly, you know that I relie on patients keeping the pain scale between 0-2 in my rehabilitation programs. It is in the 0-2 range out of 10 that I am insured that the patient is most likely not hurting themselves further, and most of the time allowing the injured tissue to heal. I try to get the pain down to 0-2 as quickly as possible, and hold pain level until they are back to complete function. 

The illustration above shows many of the ways to show this sliding scale with the green area pretty much where I need to advise patients to be functioning within. As the pain gets into the next real level of 3-4, the situation goes from tolerable to distressing. 

     Yet to ask a patient what their pain level is, is really asking them to do the impossible at times. Pain levels vary during to the day due to many factors, so I think we need minimum of 5 points during the average day to adequately assess. These points may be: first thing in the morning, during the morning, as the day goes on, with exercise, and after exercise. So, you can see that 5 points may really be 10, and it can get very complicated for an office visit. 

     In our physical therapy department, the patients are always asked how they feel before, during and afterwards. The goal of course is to have the patient feel better, in other words, have their pain go from 5 to 3 during the session. What has this to do with anything? I just think if you are really trying to rehabilitate a patient you should know more than just the average amount of pain they experienced that day.