Acute pain vs. chronic pain

I hate this pain scale! It's for healthy people who don't normally have pain. But when you have constant pain that can feel different, and have different effects, how are you supposed to categorise it? Many symptoms have been there for years. I don't always think to bring them up all the time. I notice it most when I get into a situation that I know from before when I was better. Then I notice that a whole lot of ...... have become "normal" for me.

I used to travel to Stuttgart a lot, I also worked there. When I once had a doctor's appointment in Stuttgart in December, I thought I would go to the Christmas market afterward. That was completely out of the question after the appointment. I was utterly exhausted and weary, and the very thought of getting home overwhelmed me. I experience the same thing at home, but I try to organize my day so that I don't feel this degree of exhaustion all the time. It cannot always be influenced. I do believe that it is different from when someone, usually without pain, is supposed to describe an acute pain.

Am I being understood correctly?

I was in the hospital recently. "On a scale of 1-10, how severe was your pain?" The usual question. I never know what to say, sometimes I can find adjectives. Although when I'm asked if the pain is sharp, throbbing, dull, burning, etc., I don't know. I experience all that. If I say that though, it is hard to believe me. What´s new? So numbers. I said: "5-7." For some doctors this is hardly worth mentioning, for others 5 is already "significant". I always feel like I'm not saying the right thing. Not being able to accurately say what my pain is like. It is really hard to categorize.

What does the pain scale mean?

So it is very subjective, both for the patient and the doctor. It is not as though everyone feels the same pain in the same way, nor is it as though every doctor interprets or understands what a patient says in the same way. At present, however, there is no other tool to communicate the intensity of pain. It would be very helpful if the scheme were explained in detail before it is used.

It is not the case that everyone feels the same pain, nor is it the case that every doctor interprets or understands what a patient says in the same way. Click to tweet
the beloved pain scale

The scale in words

In the American organization ProHealth the pain scale was interpreted verbally. Check it out:

  • 0 - Pain free
  • 1 - Pain is very mild, barely noticeable. Most of the time you don’t think about it
  • 2 – Minor pain. Annoying and may have occasional stronger twinges
  • 3 – Pain is noticeable and distracting, however, you can get used to it and adapt
  • 4 – Moderate pain. If you are deeply involved in an activity, it can be ignored for a period of time, but is still distracting
  • 5 – Moderately strong pain. It can’t be ignored for more than a few minutes, but with effort you still can manage to work or participate in some social activities.
  • 6 – Moderately strong pain that interferes with normal daily activities. Difficulty concentrating
  • 7 – Severe pain that dominates your senses and significantly limits your ability to perform normal daily activities or maintain social relationships. Interferes with sleep
  • 8 – Intense pain. Physical activity is severely limited. Conversing requires great effort
  • 9 – Excruciating pain. Unable to converse. Crying out and/or moaning uncontrollably
  • 10 – Unspeakable pain. Bedridden and possibly delirious. Very few people will ever experience this level of pain

Just to give some orientation - natural childbirth (no epidural or medication) is generally thought to be an 8 on the pain scale.

Who gave words to the pain scale?

This interpretation is not set in stone, but it was written by Karen Lee Richards after extensive research. Karen suffers from fibromyalgia herself. She co-founded the National Fibromyalgia Association (NFA) in 1997 and helped to create the Fibromyalgia AWARE Magazine. She has written about fibromyalgia syndrome and chronic fatigue syndrome for the New York Times. I think it's safe to say she knows what she's writing about.

If you also have difficulty with the pain scale, you could show this interpretation to your doctor, who might be able to classify your pain better if you follow it.

What still remains is the difference between acute and chronic pain. Researchers are working on a new method for measuring pain. Until then, we'll just have to work with this one.

Perhaps you get on better with the pain scale. I would love to learn your thoughts. Here you can download helpful information, different pain measurement tools compactly summarized

Picture of Ruvim Noga on Unsplash


ProHealth. (2019, May 18). The Pain Scale Chart: What it really means. Retrieved May 18, 2020, from