Meet the Other Phone. A phone that grows with your child.

Meet the Other Phone.
A phone that grows with your child.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To not understand the 1-10 pain scale (lighthearted)

87 replies

Fink · 15/02/2020 12:27

Just to claify, I'm just mildly bemused by this, I'm not actually up in arms about it, so by all means help me to clarify it but don't act like I'm trying to destroy the NHS or anything (I know AIBU can be brutal at times).

I have never understood when medical professionals ask me to rate my pain on a scale of 1-10 what the scale is actually suppposed to correspond to. I know that pain is subjective, but even so I would really appreciate some guidance as to what level of pain goes with what number. I mean, if I'm only supposed to used integers (because it would seem a bit picky to say 3.72 or whatever), then 1-10 isn't giving me a lot of leeway to distinguish between types of pain.

I'm assuming that 0 is supposed to mean no pain at all, and 10 is the worst pain imaginable: excruciating near-death agony, e.g. crucifixion (suffocating, nails through hands and feet, deep lacerations elsewhere, emotional pain etc).

Ok, so I would rate my first experience of childbirth at about a 6 at its peak, going down to maybe a 4 at times. It was an awful, long, labour resulting in a forceps and ventouse delivery without pain relief and with a large episiotomy. And I was hooked up to machines for over 30 hours so not allowed to move positions. It was by far the worst pain I have ever been in. But I can't put it on a level with hours and days of physical and emotional torture until actual death which I see in cases of abuse on the news, for example. So even though I personally have never been in worse pain, so it would be a '10' on my own experience, it would seem stupid of me to use up a 10 on that when there are clearly worse pains out there. And it was only physical pain, I had emotional support.

Another experience of childbirth was more straightforward, although still the second worst pain of my life. I would put it at about a 4, in that it was by a very long way less painful than the bad labour, but still terrible. But if I said 4 when they asked where it was on 1-10, they seem to assume that means that it's not too bad, in that I still have numbers 5-10 that it could be, but that just seems ridiculous because how could childbirth, even at its absolute worst, ever be comparable to the worst pain it is possible for a human to suffer? Obviously I didn't have the energy or inclination to have that argument at the time, I could barely speak at all, but over all the pain that was what I was thinking.

So that means I've got numbers 1-3 to play with for all other pains that are less than childbirth. I've had various infections and illnesses over the years, thankfully none too serious. But there are definite degrees of how painful they are, from 2 day migraines and third-degree burns to gastroenteritis (very unpleasant, but in waves) and milder headaches.

This scale just doesn't seem to make sense at all. There's massive uneven jumps in between numbers. You have to squeeze almost every type of pain from mild to severe into 1-3 so that you have enough numbers left for the really agonising torture. How could I go above 3 when I can see things in the news which are clearly so much worse? But on the other hand if I tell a health professional that it's a 3, the assumption is that's it's barely any pain at all, because, you know, it seems to sound like 30% pain, and that sounds low.

Has anyone ever seen any actual NHS advice on this? I would really like a chart where the average experience of different illnesses were ranked on this 1-10 scale. What I would really like is for them to use a wider ranging scale, say 1-100 or 1-1000. But given that the 1-10 things seems very widespread, what I'd like as a compromise is proper guidance on what the numbers are supposed to correspond to IRL.

OP posts:
Thread gallery
5
notanotherjigsawpiece · 15/02/2020 14:49

It’s too subjective. I was taught at medical school not to use it for this reason, though I notice a lot of other medics use it. I’ve seen some healthy adults with a sore throat complain of pain more than someone dying of metastatic cancer, it really does depend on the person.

june2007 · 15/02/2020 14:49

Birth certainly wasn,t a 10 for me. I had a D &C for a miscarriage at times it hurt, but not as bad as I thought it would. Don,t think I have high pain threshold just think I have a easier time then others.

EggysMom · 15/02/2020 14:52

If 0 is no pain and 10 is the worst pain I personally have experienced, I'd have to say that stubbing my toe (and probably breaking it, I didn't get it checked) rates as 10. That was the worst pain. But then I've never gone through childbirth (sunroof delivery), and I'm lucky not to have had toothache very often (I'd rate that around 8). I've never broken a limb. Only car crash was whiplash. considers finding a piece of wood to touch

Hepsibar · 15/02/2020 14:58

That chart is quite helpful though of course think would be useful to have examples of things which commonly hurt this much (with caveat not always). Also some sort of indication of length eg short intense etc

Bone Cancer
Amputation
Burn etc different grades
Childbirth
Broken ribs, collar bone, ankle, arm, leg, shoulder etc
Bad hips
Arthritis
Diaorreha (excuse spelling)
Shingles
Tonsilitus
Mouth ulcer
Toe stubb
Cruciate ligament

I am sure they could run all this thru a spreadsheet and come up with some weightings, so when you are asked ... but I guess different people have different pain tolerances depending on wiring of brain/nerves etc.

Bubblemonkey · 15/02/2020 15:05

I had my bladder removed - I was basically on no pain relief once my epidural came out. I wanted to be anaesthetised again until the pain started settling down, I still didn’t consider that 10/10. Boils my piss when people claim to be 10/10 & posting on Facebook. Fuck off out of here 🤦🏼‍♀️

Bubblemonkey · 15/02/2020 15:09

@Bagofoldbones endometriosis pain has landed me in resus before I was diagnosed. 160/110 blood pressure & pulse of 200+ due to pain. I was happy enough to feel sorry for myself on the sofa at home till my mum sent me to a&e cause I kept blacking out with Undiagnosed abdo/pelvic pain 😬

FreiasBathtub · 15/02/2020 15:16

@Slothkin 😂

safariboot · 15/02/2020 15:17

Indeed xkcd addressed this

xkcd.com/883/

The more objective scale linked by VivaLeBeaver is much more informative.

I'm the kind of person who never hands out top ratings, on anything. It can always be better - or worse in this case. But collapsing on the floor in the foetal position from the worst toothache I've ever had is my 9, easily. Breaking a leg on a ski slope was nowhere near; I suppose a 7 if I put weight on it, a 3 or 4 when it was resting.

I've heard that medics are more interested in change than the absolute rating. I've also heard that saying 10 doesn't get taken seriously, they assume you're exaggerating. Which I guess fucks over anyone who isn't.

KitKat1985 · 15/02/2020 15:24

Pain is always subjective subject so hard to rate, but for me 0 is no pain, with 9/10 being 'I'm literally crying or screaming with the extent of the pain'. For me labour was about an 8/9. The worst pain I have ever had is when I slipped a disc in my back. Literally every time I moved it felt like someone was putting an electric shock down my back.

For me anything up to a 3 is more an annoyance, niggling type of pain. 4-5 is this hurts a bit now and I could do with some paracetamol. 6-7 is this really hurts now and I'm taking some stronger pain relief, and I won't be able to sleep through this level of pain. Anything above 8 you probably need to seek medical attention pretty urgently as something is probably wrong.

Poetryinaction · 15/02/2020 15:29

In childbirth I genuinely would rather have died. I found the pain absolutely excruciating and unmanageable. I had back-to-back babies and bad tears. For mw that is 10. I simply can't imagine any pain to be worse. Nothing else has ever come.m close. Dry socket, sinusitis... they were very painful, but I would have them x 2 every day rather than go through childbirth again. I would have to put them at 2 in comparison. So toe stubbing is a 1.
Yeah, it doesn't work for me either!

sonjadog · 15/02/2020 15:35

My worst pain was just before this Christmas when I got an infected root of a tooth which then went on to form an abscess. It was a large infection and took two rounds of antibiotics, extra medication in the tooth and weeks to completely clear. It was so painful I couldn't speak, eat, lie down. If I touched the tooth I felt faint and like I would vomit (but I refused to let myself because that would have been even mor painful for the tooth). Painkillers only worked for a short time before becoming useless. It was 3-4 very unpleasant days before it started to get better.

I reckon that was about an 8-9 of pain. I haven't been through childbirth, but I discussed my tooth thing with a couple of colleagues who have had children and also similar tooth experiences, and they both said for them, the tooth thing was worse that childbirth. Which surprised me, as I always thought it was a ten.

alltakingandnogiving · 15/02/2020 16:03

You know, it's funny that this came up because I collect pain charts. One of my favourites is this one because of yellow, moderate person. I don't know why, but he made DD and me cry with laughter while we waited for the doctor to come in.

To not understand the 1-10 pain scale (lighthearted)
DishRanAwayWithTheSpoon · 15/02/2020 16:24

I think a lot of people are overthinking it

It's not a diagnostic tool, and yes it's subjective. It's just giving me a rough idea of how much pain you are in, if I ask this question I don't want you to think about it too much. Or compare it to your childbirth 20yrs ago, just a quick off the bat "about an 8"

It's not the only tool someone is going to use to diagnose you. I'm not going to say "Oh they said 7 not 8, can't be this then" but if you say 4 for something and the majority of people would say 9 or 10 then I'm thinking it's probably not x and is more likely to be y.

If you are in severe pain please don't go "its a 4" because you can imagine torture as a 10 and then get pissed off when medics dismiss your pain. Just say 8 or something, no one's going to hold you to it. It's really not that complex.

DishRanAwayWithTheSpoon · 15/02/2020 16:28

poetry but it does work for you, you are just overthinking it.

I have dry socket today. How painful is it "about a 9"

Cool.

There's no need to put it on a linear scale, or compare it to anything. Just how severe you feel the pain is in that moment.

I would say its how severe you want the Drs to know it is. You know if you say a 2 I'm going to think your not in pain, so just say an 8.

DeRigueurMortis · 15/02/2020 16:35

I understand where you are getting at OP.

The reality is a 1-10 scale of pain is a very individual thing and varies quite a lot by what people have previously experienced.

I'd expected childbirth to be a 8/9 on my scale but frankly it didn't touch the pain I experienced with a perforated duodenal ulcer (basically stomach acid leaking into my abdominal cavity). That was an 8 (because I can "imagine" pain worse - serious burns/amputation etc).

Childbirth by contrast I'd put at a 6 tops at its worst but most of it at a 4.

The other aspect is also how prolonged the pain is wrt your ability to tolerate it.

Intense but short lived pain is arguably less traumatic than less intense pain suffered for hours/days.

All that said, in a healthcare setting my assumption has always been (when asked) is to provide HCP's a guide to your ability withstand pain in an effort to help manage it as best as possible and keep you comfortable - the fact that someone else with the same issue might say it's a 4 is irrelevant if you're feeling in agony at level 8.

thecatfromjapan · 15/02/2020 16:37

Agree OP.

My uterus ruptured during childbirth, without pain medication. I remember trying to coherently form the thought that I might go mad with the pain - but couldn't. I couldn't find my 'I' in the midst of it.

When I'm asked to rate pain, I begin by explaining that's a '10' for me.

But, yes, I overthink.

I like LiveTheFruit's scheme. It makes more sense to me.

TheNoodlesIncident · 15/02/2020 18:46

I think if you use it to explain how tolerable your pain is to you, at that time, it will be a useful guide. I've had a headache which hurt so badly that I sat by a radiator on maximum and deliberately leaned bare skin against it briefly, because in the second of the radiator burn pain, the headache pain was diminished. I did this over and over. If you had asked me then I would have said "I can't stand it, make it stop" which would translate as a nine I would think.

I've had further headaches that have been bad but nowhere near the scale of that one, but some have resulted in my sloping off to a dark quiet room as I just can't cope with brightness and noise exacerbating the pain - maybe a seven. Definitely not something I can ignore and just get on with things. On the other hand, I've had headaches that have been a low-level grumbling, not pleasant and I definitely know they're there, but I have been able to potter around, get things done and just hope they don't get worse. Those I would score about two or three.

I've been really lucky and not broken any bones or suffered serious injuries or illnesses, just minor stuff.

(As an aside, I don't like the use of "complaining" to refer to a patient saying how they feel. I know logically it's just a medical term, but I find it a bit annoying. "Patient is complaining his head is hanging off" Well yes, but you did ask how he was! Grin)

DecemberSnow · 15/02/2020 18:53

Andromeida59
100% agree... I'm the same...

When someone says "You dont look ill"
Gives me the rage

yellowallpaper · 15/02/2020 19:55

It's entirely subjective and immediate to the time the question is asked. What your pain was in childbirth relates only to that experience, and not to your current issues, whatever that are.

lottiegarbanzo · 15/02/2020 20:02

I agree, it's unclear and potentially meaningless.

I think a lot of people give the answer they think is wanted / will get them what they want, so depending on whether they want pain relief or not.

lottiegarbanzo · 15/02/2020 20:07

I hate the term 'overthinking'. If the 0-10 scheme was clear and well explained, no-one would need to apply any extra thought or ask questions. It isn't, so they do.

The fault lies with the poorly conceived scheme, not with the people pointing out that it is ill-conceived.

QuixoticQuokka · 16/02/2020 11:59

lottiegarbanzo I agree.

Just saying the number that comes into my head is not going to work if my 'it's a 2' means I need paracetamol, and 'it's a 4' means 'can I have the co-codamol please?', but the average person would use different numbers to mean the same thing.

glenhaggis · 16/02/2020 12:01

I wouldn't have known where to go with it until I had gallstones which I'd put at 10 but then there are different sorts of pain and sometimes I'd feel like a stubbed toe was 8 depending on my mood at the time. A little toe stubbed on the edge of kitchen units is extremely swear worthy Grin

INeedToGetHealthy · 16/02/2020 12:15

I recently went to a pain management appointment and I think they misunderstood what I charged on the 0-10 pain scale.
When I had gallstones a few years ago I would have classed that as a 9, as I could not function but was conscious. Just before DS1 was born, my liver ruptured from HELLP Syndrome. I would have classed that as a 10+ just before I passed out and was dying.

So my pain management assessment I rated the worst pain as being an 8 even with morphine.

Cornettoninja · 16/02/2020 12:17

This is the pain scale that works for me! It’s funny but it gives me a solid reference to refer to.

The pain scale was useless for me during labor. I kept saying things like ‘it’s an 8’ ‘no this is an 8’ ‘nope this is definitely an 8’ until I got to the point I asked the midwife to cave my skull in (GrinShock) because my frame of reference kept changing.

It’s a bit abstract for some people (me) I think. Pain is pain and it’s hard to quantify it succinctly.

To not understand the 1-10 pain scale (lighthearted)
Swipe left for the next trending thread