Pain Scales

It is currently impossible to objectively measure pain.

At the same time, sometimes we need to know how much something hurts to guide treatment.

Humans have come up with a lot of pain scales, and here are some of the ones I've tripped over.

The generic pain scale

A 0-10 scale of pain in a rainbow where the top of the scale (10) is in a dark red and the bottom of the scale (0) is light blue.

From bottom to top, the levels are:

• 0. no pain. I have no pain
• 1. Minimal. My pain is hardly noticeable.
• 2. Mild. I have a low level of pain. I am aware of my pain only when I pay attention to it.
• 3. Uncomfortable. My pain bothers me but I can ignore it most of the time.
• 4. Moderate. I am constantly aware of my pain but I can continue most activities.
• 5. Distracting. I think about my pain most of the time. I cannot do some of the activities I need to do each day because of the pain.
• 6. Distressing. I think about my pain all of the time. I give up many activities because of my pain.
• 7. Unmanageable. I am in pain all of the time. I give up many activities because of my pain.
• 8. Intense. My pain is so severe that it is hard to think of anything else. Talking and listening are difficult.
• 9. Severe. My pain is all that I can think about. I can barely talk or move because of the pain.
• 10. Unable to move. I am in bed and can't move due to my pain. I need someone to take me to the emergency room to get help for my pain.

Another basic pain scale

A 0-10 scale of pain using 6 smilie faces in a row. Above the faces it says choose the face that best describes how you feel. The faces are drawn in blue and there are no background colors inside the faces.

From left to right, the levels are:

• 0. No hurt. The face is smiling broadly.
• 2. Hurts little bit. The face is smiling, but less broadly.
• 4. Hurts little more. the face is no longer smiling and the mouth is in a straight line. The eyebrows are up as if concerned.
• 6. Hurts even more. The eyebrows are in a sad position and the mouth is slightly frowning.
• 8. Hurts whole lot. The face is frowning and the eyes are drooping with distress.
• 10. Hurts worst. The frown is very deep and the face is sobbing with visible tears going down the cheeks.

In Boyfriend Doesn't Have Ebola. Probably. by Allie Brosh, she criticizes the scale, reinterpreting it to mean as follows:

0: Haha! I'm not wearing any pants!

2: Awesome! Someone just offered me a free hot dog!

4: Huh. I never knew that about giraffes.

6: I'm sorry about your cat, but can we talk about something else now? I'm bored.

8: The ice cream I bought barely has any cookie dough chunks in it. This is not what I expected and I am disappointed.

10:You hurt my feelings and now I'm crying!

The Hyperbole and a Half pain scale

From the article Boyfriend Doesn't Have Ebola. Probably. by Allie Brosh.

Allie thought that the pain scale above was ineffective, and drew her own. It provides 12 levels of pain using stick figures consisting of heads and arms. To describe these two images, I'll provide a number, a visual description, and then Allie's textual description of what that drawing means.

0: A face with normal eyes and a flat line for a mouth. The left arm is waving hello. Hi. I am not experiencing any pain at all. I don't know why I'm even here.

1: The arms are down to the sides but stiffly. One corner of the mouth is turned down. I am completely unsure whether I am experiencing pain or itching or maybe I just have a bad taste in my mouth.

2: The face is frowning, and the hands are together in front of the chest. I probably just need a Band Aid.

3: The face is frowning more deeply and the hands are pulling into fists. The eyes are dilated. This is distressing. I don't want this to be happening to me at all.

4: The mouth is now frowning but it is also open. The eyes are still dilated. The hands are rising toward the face. My pain is not fucking around.

5: The eyes are not only dilated but starting to fill with tears. They are putting their hands in their mouth. Why is this happening to me??

6: The eyes are full of tears and a few are falling. The frown is so deep as to reach both edges of the face and some tears are falling. The hands are up in an almost protective position. Ow. Okay, my pain is super legit now.

7: Both eyes are sobbing, the whites of the eyes are huge and the eyeballs are now red. I see Jesus coming for me and I'm scared.

8: The red eyeballs have grown and the person is clearly screaming. I am experiencing a disturbing amount of pain. I might actually be dying. Please help.

9: The eyes are fully red, the mouth is frowning and you can see the depth of the mouth by the pink deep inside. They have started leaning backwards. I am almost definitely dying.

10: The person looks crazed. One eye is fully dilated with a red eyeball rim, the other has a tiny red eyeball in the center. The mouth is still screaming. I am actively being mauled by a bear.

11: The face has turned pink, the person is drooling, their eyes are closed, their hands are at their cheeks. Blood is going to explode out of my face at any moment.

Too Serious For Numbers: There's blood seeping out of both eyes and the wide open mouth, as well as running down both arms. You probably have ebola. It appears that you may also be suffering from Stigmata and/or pinkeye.