Bonnie Eisenman bio photo

Bonnie Eisenman

Software engineer, author, knitter, Esperantist. Member of NYC Resistor and author of Learning React Native.

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Time for some non-tech-blogging! I have some chronic health conditions, and pain is a topic I think frequently about. Here’s one of my biggest pet peeves: the pain scale. Today, once again, I faced the dreaded question.

“How would you rate your pain on a scale of one to ten?”

This is a useless question. What’s one? What’s ten? A migraine? Breaking a limb? When you live with chronic pain you’re always in pain, and acute pain parses differently from the background radiation of daily life. Sometimes it feels like doctors interpret this question as: less than five and you’re not worth dealing with; more than eight and you’re lying.

Pain is part of my daily life. My base level of pain is higher; my tolerance is also higher, because it has to be. (Up until recently I wouldn’t notice, e.g., when I spilled boiling water on myself. After all, it hurt less than my usual pain levels.)

Here’s a more useful scale that I stole from tumblr. I like it because it’s more descriptive, and I keep a daily pain journal using this scale. Some people have asked me to share it, so here it is.

I don’t have a proper citation for this scale (sorry!), but it’s similar in some ways to the Mankoski Pain Scale.

Pain Scale

10: Unable to move. I am in bed, and cannot move. I need to be taken to the ER.

9: Severe. My pain is all that I can think about. I can barely talk or move because of the pain.

8: Intense. Hard to think of anything else. Talking and listening are difficult.

7: Unmanageable. I am in pain all the time. It keeps me from doing most activities.

6: Distressing: I think about my pain all the time. I give up many activities because of my pain.

5: Distracting. I think about my pain most of the time. I cannot do some activities each day.

4: Moderate. I am constantly aware of my pain, but can continue most daily activities.

3: Uncomfortable. My pain bothers me, but I can ignore it most of the time.

2: Mild. I have a low level of pain. I am aware of it only when paying attention to it.

1: Minimal. My pain is hardly noticeable.

0: No pain.

So like…why?

Journaling my pain levels is useful - this way I can track my pain levels relative to treatment, medications, sleep, illness, travel, etc. And having a descriptive pain scale based on functional criteria provides a somewhat more objective, translatable way to convey a very personal and internal experience.

Right now, for the record, I’m usually a 4. Without medication I’m consistently a 7 or an 8.

0 is a lie, right?