The Pain Scale & How to Use It Well

Do you remember the last time you went to the doctor? If it was within the past couple of years, chances are, you were asked to “rate your pain on a scale of 0 to 10 with 0 being no pain, and 10 being the greatest amount of pain humanly possible.” What does that even mean?? I’m going to shed some light on this enigmatic pain scale, so the next time you or a loved one goes to the doctor, you can get the best care possible.

Patients hate the pain scale

You are suddenly put on the spot. The nurse or doctor is waiting for you to put a number on what you’re experiencing. It’s the worst pain you’ve ever felt, but is it a 10? It is if you feel like a bear is gnawing on your leg while bees sting your eyeballs and you have your hand caught in an ever-tightening vice. Crazy, right? But that’s a 10. It’s pain that is nearly intolerable. Every once in a while a doctor will see a 10, but the patient is in too much pain by that time to even communicate the number. That’s a 10.

There is the opposite problem as well. I have a relative who was in the hospital in excruciating pain and he was inaccurately reporting his pain at a much lower level than it actually was. Once he understood the pain scale and could express what he was experiencing, the doctors could properly treat him.

Pain scale

Doctors hate the pain scale

Doctors are required to record the number at which you rate your pain along with your vital signs (temperature, oxygen, and blood pressure). That doesn’t mean they like it. They know how subjective the pain scale is. We all know someone who moans for hours about a hangnail. We also know someone who would walk around with a broken bone for days without going to the doctor.

We’re all made different. We feel pain differently, but we also interpret it differently. some people are really in touch with how they are feeling and like to report those feelings to everyone and anyone who will listen. Other people feel like it’s complaining and keep their pain to themselves, not wanting to make a fuss.

The 0-10 scale, itself, is a problem

Then there’s the problem of the scale itself. Most people don’t know what a 7 means. If you were rating a restaurant from 0-10, a 7 would seem okay, but not stellar. On the pain scale, 7 means a lot of pain! Thankfully there are some tools to help you properly assess your pain levels.

The Wong-Baker Faces

Wong Baker Pain Scale

A helpful tool for people who are new to the pain scale is the Wong-Baker Faces. The scale is a visual interpretation of the pain scale, developed by Donna Wong and Connie Baker. It was originally created to help children express their pain. It’s now common to see this scale in emergency rooms and clinics for patients of all ages. It’s intended for self-assessment and isn’t intended to be used by a 3rd party to assess someone else.

Ouchie by Ouchie, LLCApp for pain assessment

There are also apps that can help you track and assess your pain. One example is Ouchie, available (and FREE) through iTunes. This not only helps you to track your specific pain, but it also connects you to an online community of people with your condition and gives you ideas of how to manage your pain. Ouchi is only one example of the tracking apps out there. Try more than one and decide what works best for you.

Imagination and Communication

It takes some imagination to express your pain levels. My bear/bee/vice illustration from earlier is a good example of visualizing the pain to more accurately report it. It takes some creativity, but it can help you to decide, is this really a 10, or is it more like a 7 (the bear without the bees and the vice)?

There’s no substitute for clear, honest communication. Talk to your doctor if you’re unsure of how to assess and express your pain levels. Also, having a caregiver come with to appointments is a great way to stay accountable. They see you all the time and can let you know if they think your assessment may need a little retooling.

What are YOUR thoughts?

I’d love to hear in the comment section, below. I appreciate my readers as well as the writing community. To show that appreciation, I use Comment Luv. Just leave a comment below and your latest post will get a link next to it. Thank you!

About Heather Erickson

I am an author, writer, and speaker and homeschooling mom of 3. Since my husband, Dan was diagnosed with stage IV lung cancer in 2012, I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness.

My goal is to help people face cancer with grace.

My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on

The Erickson Family, Photo by Everbranch Photography

2 thoughts on “The Pain Scale & How to Use It Well”

  1. I struggle with the pain scale because I’m never sure what to say. It’s hard to put a number on pain –especially when it’s subjective.

    • A few days ago, I had to go to the ER for high blood pressure. I was having discomfort, pressure, but not what I would call pain. Still, I had to give it a number. It really is difficult, even when you know the drill. I explained what I was experiencing and that I didn’t consider it pain, but it was definitely uncomfortable–unbearable, even. I think if you’ve explained how you are arriving at your number, it’s really helpful.

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