Tell anybody in a health care setting that you’re hurting, and they always want a number. “How bad is the pain on a scale of one to 10,” they ask, “where one is no pain, and 10 is the worst pain you can imagine?”
I imagine a 10 is akin to a US Civil War soldier getting a limb amputated with a rusty saw. A friend of mine says she always imagined the pain machine from The Princess Bride. Severe pain for her was a two. Unbearable pain, one time after surgery, she rated a three. This is not how the scale is meant to work.
(On the flip side, people who work in health care have plenty of stories of patients claiming their pain is at a 10, even as they sit comfortably in the waiting room or walk without limping on an injured foot. This is not how the scale is meant to work either.)
It turns out that the scale is not meant to represent the entirety of human experience real and fictional, but the spectrum of pain that an average person might reasonably experience.
I rated childbirth, hands down the worst thing I had ever experienced, as “maybe an eight” as I was begging for an epidural. Later on, a doctor, who knew I’d had a kid, asked, “How’s your pain, from one to 10? Ten is labour.” Ohh.
How to Calibrate Your Personal Pain Scale
If you’re lucky you’ll find yourself in a hospital room with a poster of faces for each level of pain. At a two, the face is still smiling. At six, it begins to frown. By eight, it looks quite distressed. The face at 10 is weeping.
There are a variety of pain scales such as this that provide some benchmarks to help you out. Take a look now, because they’re rarely around when you need them. Here are some tips:
- One to three is mild pain. If you’d describe it as annoying, you’re in this territory.
- Four to six is moderate pain. It hurts but you can probably distract yourself or ignore it, at least for a little while.
- Seven and up is severe pain. You can’t ignore it. It’s stopping you from walking or sleeping or living normally.
If you have trouble figuring out where you are on the scale, it’s OK to ask! One time a physical therapist told me I could try running, despite an injury, but to stop if the pain got to be around a six or seven. How much pain is that? I asked. “If you have to alter your gait,” she said. “If you’re limping, that’s a seven.”
For those of us with active imaginations: Unbearable pain is a 10. Labour is a 10, a rusty hacksaw amputation is a 10, all of the settings on the Princess Bride pain machine are a 10. Sure, some of these may be worse than others, but the pain scale is not asking you for that nuance.