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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:
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TheHagOnTheHill · 16/02/2020 12:22

It's to deal with people like my mum who response how was the pain was that it wasn't to bad.Given the number scale it was a 8-9, she'd broken her hip and thank to her stoical response got no pain relief for 24 hours!

LonginesPrime · 16/02/2020 12:24

It's simple, OP - you just say 8 if you want the drugs, and 4 if you just want them to know you're not comfortable.

FudgeBrownie2019 · 16/02/2020 12:29

DS1 broke his leg awfully last year - there were bones protruding from his body at one point and an assclown doctor marched past and went "what would you say you are on the pain scale?"

DS1 didn't get a word in - I immediately announced "when patients have parts of their body sticking out that are meant to be inside is the pain scale necessary? Pretty certain you can assume he's a 10 and get on with putting the insides back inside" and the nurse next to us laughed like a small child for ages. I understand the need for a pain scale when you can't guess but even then it's such an odd thing when we know people's pain tolerance levels vary so vastly.

QuixoticQuokka · 16/02/2020 12:34

It's simple, OP - you just say 8 if you want the drugs, and 4 if you just want them to know you're not comfortable. I would say a 4 and a 2 in those circumstances, so not so simple. Compared with some of the pain scales listed, their 1-6 is my 1-4.

hazell42 · 16/02/2020 13:00

I actually think it is quite useful. Not as a way of measuring pain. It is completely useless at that.
But it is excellent at measuring your resilience and tolerance of pain, and where your pain threshold is. You mention the worst part of a brutal 30 hour labour as a 6, which means that you have a pretty high pain threshold.
So, if a nurse asked you if you were in pain, and you said you were 'a bit uncomfortable', they would then know that you are in absolute bloody agony and they had better get the morphine, quick.
If you rated stubbing your toe as a 10, you'd get 2 paracetamol.
I'm pretty sure that what is being measured is you and not your pain

Itswrongtowishonspacehardware · 16/02/2020 13:11

My worst type of pain is waking up in the night with cramp in my calf!

Pppppickupapenguin · 16/02/2020 13:17

Knocking my frozen shoulder was a 10. I almost passed out.

On a synto drip during childbirth was an 8.

Stubbing my toe around a 4, even though I broke it.

Toothache, also a 10 even though it's a different kind of pain to my shoulder.

Cornettoninja · 16/02/2020 13:30

That’s another variable though isn’t it? Stubbing your toe is short sharp pain so 4 is fair but if you were experiencing that same pain for two hours your rating would rise.

joffreyscoffees · 16/02/2020 13:32

There's a lot of health professionals that think the pain scale is a load of tosh. Like you say, pain is subjective. What is a 2 for person A might be an 8 for person B.

cushioncovers · 16/02/2020 13:35

They 1-10 pain scale is usually explained as if 10 is the worst pain you've ever experienced and 1 is the least, where you you said your current pain is now? And when a patient says it's a 9 but they are asking for a coffee and texting their mates the staff are like 🤔🤔

Cornettoninja · 16/02/2020 13:42

And when a patient says it's a 9 but they are asking for a coffee and texting their mates the staff are like

But why? The patient in that scenario was asked about their experience with pain, maybe their 10 in that context wasn’t painful enough to be incapacitated but they’re still experiencing a pain out of the ordinary enough for them to seek medical attention.

This is what makes it hard to know how to place yourself on the pain scale. My experiences with pain may be disjointed with the HCP’s interpretations. Who gets final say on whether the pain being experienced is a valid symptom or not. I can power through pain caused by injury (open wound/burn etc) but really struggle with musculoskeletal pain.

oldfashionedtastingtea · 16/02/2020 13:43

They asked my mum once how she rated her pain. She said 5. They then told her she couldn't have lunch. At dinner time they asked again. She asked what it needed to be to get dinner. They said 4 or lower. Then it's a 4 mum said. Love her for that.

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