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Types of Pain Scales
Pain Scales Help You Rate Your Level of Pain

By Carol & Richard Eustice, About.com

Updated January 07, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Pain scales help you rate your level of pain so it can be communicated to your doctor, other health professionals, or even your family. It's a self-reported pain level so many patients are leery about its "accuracy." Some patients will say "What does a 4 feel like?" or express uncertainty about the whole pain scale concept. It's a somewhat valid point. What I might call a 7, you might say is a 3. The value still comes in comparing your ratings. If you say this week your pain is a 4 and next week you say your pain is a 6, that shows worsening of symptoms.

There are different types of pain scales -- verbal, numerical, and visual pain scales. Let's see how they are similar and how they are different.

Verbal Rating Scales

Verbal pain scales, as the name suggests, use words to describe pain. Words such as no pain, mild pain, moderate pain, and severe pain are used to describe pain levels. A score from 0 to 3 is assigned to each of those word pairs and is used to measure the pain level.

Numerical Rating Scales

A numerical scale with the range of 0 to 10 is another type of pain scale that is used. The words "no pain" appear by the "0" and "worst pain possible" is found by the "10." You are asked to choose a number from 0 to 10 that best reflects your level of pain.

Visual Analogue Scales

VAS or visual analogue scales use a vertical or horizontal line with words that convey "no pain" at one end and "worst pain" at the opposite end. You are asked to place a mark along the line that indicates your level of pain.

Wong-Baker FACES Pain Rating Scale

With the Wong-Baker pain scale, six faces are used that are numbered 0 to 5 underneath:

Face 0 is a happy face (no hurt)
Face 1 is still smiling (hurts a little bit)
Face 2 is not smiling or frowning (hurts a little more)
Face 3 is starting to frown (hurts even more)
Face 4 is definitely frowning (hurts a whole lot)
Face 5 is crying although you don't have to cry to choose this face (hurts the worst)

The FACE pain scale would be particularly useful for children who may not have verbal skills to express their pain level.

Bottom Line About Pain Scales

The aforementioned pain scales focus on the severity of your pain but they really don't delve into any other aspect of pain such as qualities of pain (sharp, dull, throbbing) or other characteristics of pain (annoying or unbearable). There are questionnaires designed for that purpose. The questionnaires gather more details about your pain than what can be derived from pain scales.

You will find a pain scale in almost every doctor's office. When you are asked to rate your pain, be honest. But don't stress over whether you gave the right answer. The value of the pain scale is in comparison from week to week or doctor visit to doctor visit.

Sources:

Pain Rating Scales. The University of Texas M.D. Anderson Cancer Center. Patient Education. 04/05/2001.
http://www.mdanderson.org/pdf/pted_painscale_faces.pdf

Pain Rating Scales. The University of Texas M.D. Anderson Cancer Center. Patient Education. 04/05/2001.
http://www.mdanderson.org/pdf/pted_painscale_numeric.pdf

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