Understanding Medical Pain Scales: How They Work and What Are Their Limits

Ever notice how some people seem to brush off pain like it's no big deal, while others wince at even a minor bump? That’s because pain is a deeply personal experience. There’s no lab test or scan that can definitively measure pain. What one person calls “severe,” another might describe as “manageable.” Pain scales were created to help, but are highly problematic, especially for chronic pain sufferers.

What Are Pain Scales, Anyway?

Pain scales are essentially communication tools. If you’ve ever been asked to rate your pain on a scale of zero to ten—where zero is no pain and ten is “worst pain imaginable”—you’ve encountered a Numeric Pain Intensity Scale (NPIS). This type of scale is simple: pick a number that represents how much you’re hurting.

Other scales include visuals, like the Faces Pain Scale, which shows different facial expressions ranging from happy to crying. It’s particularly helpful for children or anyone who might struggle to articulate their pain verbally. There’s also the PEG-3 scale, which asks three questions about how pain impacts your life. And for those who love details, the McGill Pain Questionnaire (MPQ) offers a list of 78 words like “stabbing” or “itchy” to describe pain more precisely. 

The Upsides of Pain Scales

Pain scales are helpful for a few reasons. First, they’re easy to use and don’t require much equipment or training. They’re also great for tracking changes over time. For example, if your pain drops from an 8 to a 4 after starting a new medication, that’s a clear sign it might be working. Pain scales can also help clinicians tailor treatment plans more effectively.

The Downsides: When Pain Scales Fall Short

As useful as pain scales are, they’re far from perfect. The biggest issue? They’re subjective. What feels like a 6 to you might feel like a 3 to someone else. If you are a chronic illness sufferer, the traditional pain scales really aren’t applicable at all. This chart is much more accurate than traditional pain scales.

The Science of Pain: More Than Just a Number

Pain isn’t just a physical sensation; it’s influenced by your emotions, psychology, and even social factors. According to Dr. Lauren Atlas from the NIH, pain is a “decision-making process” shaped by various factors like anxiety or relaxation, which can make the same pain feel different at different times .

Research is ongoing to better understand pain, but we’re not there yet. While some studies use brain imaging to observe pain, the results are still not practical for everyday use. As Dr. Goertz puts it, “There is nothing I am aware of that would reliably predict a patient’s pain experience” based on current technology.

Jeremy Andrew Davis posted a video on this topic.

@jeremyandrewdavis Rate how much you hate the Pain Scale. 😅 ##PainScale##PainChart##ChronicPain##Spoonie##MedicalSchool##BetterMedicine##ListenToPatients##ChronicPainWarrior##Parasympathetic##FightOrFlight##SympatheticNervousSystem##Stress##pain##painThreshold##PainTreatment##BadDoctors##BadNurses##HealthTools##Heath##Healing ♬ original sound - Jeremy Andrew Davis

With over 7500 comments, most people sharing their pain scale stories, this is an issue not to be taken lightly

Moving Beyond Pain Scales

Today’s healthcare providers are moving away from relying solely on pain scales. Instead, they’re focusing on how pain affects your life. The goal is to put you—not just your pain—at the center of the discussion. After all, it’s not just about reducing pain to a zero; it’s about helping you live your life fully, despite the pain.