Helping Health Practitioners to Understand Your Pain and Pain Severity

So… for many of us living in chronic pain, visits to a Doctor’s office can prove problematic when asked to describe our pain using a numerical rating system. Although quick and convenient, how then do you best describe your pain to a Doctor, Nurse or other health care practitioner especially if your level of pain constitutes “significant” or “severe” pain (beyond the fact, of course, that you’re not writhing about and/or screaming through-out your visit with them)?

Nurses and Doctors often ask you to state your level of pain using the 0-to-10 pain scale (where 0 represents no pain & 10 represents the worst pain you can imagine) and that can be tricky, especially if your level of pain ebbs and flows, which of course it naturally does.

Many other factors can affect your response such as whether or not you are taking pain medication and if so, when you last took it, if you are presently sitting, standing or lying down, and how that impacts your pain, the list of variables goes on and on and can make responding in a simple 1 to 10 fashion quite challenging.

To help you get a more objective and better handle on what constitutes chronic pain and “high-impact” aka severe chronic pain, and prepare yourself to describe your pain, it may be useful to check out the quick assessment tools formulated for the National Pain Strategy Papers:

Chronic Pain Screener

(Questions from Appendix D)

Have you had pain on at least half the days for the last 6 months?

                  *If you answered yes- that is considered chronic pain

Over the last six months, on about how many days have you had pain? 

a. I have not had pain. 

b. I have had pain, but on less than half the days.  

c. I have had pain on more than half the days, but not every day. 

d. I have had pain every day, but not all the time. 

e. I have had pain all day, every day, without break.

*From a. to e. these represent a scale from mild to moderate to severe pain, respectfully.

1.  In the past 7 days, how would you rate your pain on average?

____________|____________

0                                                                           10

0=No pain                          10= Worst imaginable pain

2. In the past 7 days, how much did pain interfere with your day-to-day activities?

____________|____________

0                                                                       10

 0=No interference            10=Completely interferes

3. In the past 7 days, how much did pain interfere with your enjoyment of life?

____________|____________

1                                                                       10

0=No interference               10=Completely interferes

Find the sum of the three  0-10 pain ratings:

Mild               < 12

Moderate          12 to 20

Severe            21 to 30

NOTE: If only two pain ratings are available, divide by the sum by two and multiple by 3 to obtain an estimated sum score.

Determining High-Impact Chronic Pain 

(Questions from Appendix E)

• Once you have determined that in fact you do have chronic pain, further indicators of the severity of your chronic pain are:

Over the past 6 months because of pain…

I have had trouble doing my usual work (including work for pay, work around the home, volunteer work).

            Never      Rarely       Sometimes       Usually       Always

_____________|____________

Mild                   Moderate                 Severe

B. I have had trouble doing my regular social and recreational activities (such as visiting friends, going to the movies, attending clubs or religious activities).

      Never      Rarely       Sometimes       Usually       Always

____________|____________

Mild                   Moderate                 Severe

C. I have had trouble taking care of myself (for example dressing, bathing, or feeding myself).

Never      Rarely       Sometimes       Usually       Always

____________|_____________

Mild                   Moderate                 Severe

---

These guidelines were created by the National Pain Strategy Federal Stakeholders: Center for Disease Control, Food and Drug Administration, Navy Personnel Command, Office of the Surgeon General, Regional Health Administrators, and Substance Abuse and Mental Health Services Administration.

And other collaborators such as: • public health organizations • professional organizations • health, long-term services and supports, and social services providers • public and private insurers • human resources professionals • health care providers • credentialing bodies  • major retail pharmacy chains • National Association of Boards of Pharmacy • professional pharmacy organizations and pharmacists • pain patient advocacy organizations and people with pain • and addiction and opioid use disorder advocacy organizations