My daughter is a Pediatric RN, currently studying for her Nurse Practitioner exam and we got into a conversation about pain scales. I, like most of you, have always been presented with the standard pain scale by doctors and asked to rate what my usual pain level is and what it was at the time. She pointed out to me that pain measurement has been found to be variable, particularly for chronic pain sufferers.
“Mom, when you have pain all of the time, you have to ignore it to an extent just to function. The more you are able to ignore it, the less accurate that pain scale will be. That is why they have come up with several chronic pain scales,” she said.
Well, that certainly makes sense, doesn’t it? And yet in twelve plus years of chronic pain, I have never been presented with that chronic pain scale. There are many to choose from out there, but here is a side by side comparison that shows you the difference.
Regular Pain Scale
This image of the American Chronic Pain Association Quality of Life Scale comes from an article published a few years ago in The CUT. The article deals with how chronic pain has contributed to opioid use, but focus on what they are saying about chronic pain and the physical changes it can cause in our brains. Click on the image to go to the original post in a separate window.
There are other possibilities for chronic pain assessment, but you see the trend. Looking at our functionality, how our pain FEELS to us and affects our lives, rather than the smile you often see on our faces as we deal with our pain so others won’t have to.
Keep this in mind when you are dealing with your doctors, because most of us are not presenting them with the nonverbal cues for pain that they are trained to observe. Drop the mask, my friends, and let them see your pain on your face if you can. After so many years of dealing with chronic pain, we can give those Oscar-winning actors a run for their money, so have mercy on your medical professionals and give them the real deal.
This chronic pain scale, created in emojis, illustrates just what we are talking about!
One more thing…if your doctors are not asking you how your pain is affecting your daily life and activities…tell them. Chronic pain assessment needs to have a historical element to it to be an effective diagnostic tool. If you are going to a pain specialist, they usually get this distinction but your regular doctor may not so help him or her out and have that conversation or ask for a chronic pain scale.
Good luck out there!