At some point, you’ve probably seen a doctor or dentist or physical therapist who asked you to rate your pain on a scale of 1 to 10.
But how, exactly, is that possible? What does “2” feel like? What makes “3” different from “4?” And if you’re at a 10—the worst pain imaginable—can you still be conscious and speaking? The first time I had a migraine, I would have described it as the worst pain imaginable, but after a surgery that was meant to remove an adrenal gland tumor, I proved that assumption wrong.
At the time, there was a poster beside my hospital bed with the words “PAIN ASSESSMENT TOOL” at the top in shouty caps. Beneath the letters were the numbers 1 to 10, and below the numbered scale was a row of cartoon faces meant to demonstrate what your pain was supposed to look like. At least one of them looked like a constipated emoji.
- 0 was a verdant green smile: No Pain
- 1 to 3 was an uncomfortable chartreuse: Mild
- 4 to 6 was a pasty amber grimace: Moderate
- 7 to 9 was an alarming orange frown: Severe
- 10 was a bawling red nevus: Worst Pain Possible
I remember the nurse pointing to the center of the spectrum and asking, “How is the pain? About a 5?”
Already at a loss to describe how I was feeling, I was baffled. How could anyone be sure of how this scale of 1 to 10 applied to someone else?
“Nine,” I said, and I could tell from her expression that this was the wrong answer. I insisted, “It’s not a 10, but it is a 9.”
“Okay . . .” she said, tapping her pen on her chin.
Looking back, I realize that the only right answer is this:
Pain is personal. It’s unique. My pain and your pain are not interchangeable. And mine certainly does not look like a constipated emoji.
How, then, can we truly describe or qualify our unique pain when we experience it? Here are a few alternatives to 1 through 10:
Use metaphors that have meaning to you
On the way home from that surgery, I felt as though every bump on the freeway sent a javelin of pain through my belly. Javelins are long. They could pierce straight through your body. They are frighteningly sharp. A javelin of pain is excruciating. High on the scale. Lower on the scale might be a needle or pin. Perhaps other sorts of metaphors resonate with you: the crush of a heavy weight or or the pressure of a vice. Pick a set of metaphors that resonate for you when communicating about your pain—and use them consistently.
Choose your adjectives intentionally
Pain can be sharp or dull, hot or cold. It can shoot quickly through you before disappearing, or linger like a bad memory you just can’t shake. Deep or superficial, narrow, pointed or suffocating—these are other things your pain might be. The list goes on and on. Think about the adjectives that come to mind when you’re in pain. Jot them down and build a lexicon to use when needed.
Talk about how the pain makes you feel
Does your pain urge you to lie down for fifteen-minutes before resuming your activities, or command you to stay in bed all day? Does it suggest that you whimper softly until it passes, or order you to curl up in a ball and scream? Only you can gauge your pain’s effect on…you. Try talking about this effect instead of picking a number.
Because pain is complex, you might need to pick and choose from each of these categories, mix and match in order to convey the sentiment that best describes your experience in a given moment. “A pin prick that makes me want to whimper softly before it passes.” “A vise gripping my temples and making my eyes feel too big for their sockets. I’m afraid to move.” (That was me after my first surgery.)
Whatever the case may be, remember: there is no right or wrong answer. Only yours.