Clearing's Chronic Pain Blog


How to Talk to Your Doctor: Pain Measurement and Pain Tracking

The Clearing Team
The Clearing Team

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Since pain is a subjective and uniquely personal experience, doctors rely on pain assessment tools to “measure” pain. These tools allow you to communicate vital information to your doctor, such as the location and severity of your pain. 

They also shed light on how pain impacts your emotional well-being and ability to function. Additionally, they help track the effectiveness of specific treatments. Some examples of pain assessment tools include pain scales and body diagrams.

Pain scales 

Generally, pain scales fall into two separate categories: unidimensional and multidimensional. Unidimensional pain scales are usually brief and straightforward, focused on measuring your pain levels alone. Multidimensional pain assessment tools frequently consist of in-depth, detailed questionnaires that ask about pain levels as well as other dimensions of your situation, like asking about your mental wellbeing and functional capabilities. 

Unidimensional pain scales

Unidimensional pain scales help reveal the intensity of your pain. Some examples of commonly used unidimensional pain scales include the Visual Analogue Scale (VAS), Numeric Pain Rating Scale (NPRS), Verbal Rating Scale (VRS), and the Wong-Baker Faces© Pain Rating Scale.

Visual Analogue Scale (VAS)

The Visual Analogue (VAS) Scale is a simple 10-cm (roughly 4 in) straight line with two endpoints. One endpoint indicates no pain at all, and the other endpoint indicates unbearable pain. You mark an “X” on the line to illustrate the intensity of your pain level. By measuring the distance from zero to the “X,” your doctor calculates a pain score. 

Numeric Pain Rating Scale (NPRS) 

The Numeric Pain Rating Scale (NPRS) asks you to rate the intensity of your pain on a scale from 0 to 10 points, where 0 means no pain whatsoever and 10 means unbearable pain. Your doctor calculates the average intensity of your pain over the previous 24 hours.

Verbal Rating Scale (VRS)

The Verbal Rating Scale (VRS) asks you to use words such as none, mild, moderate, severe, or intense to best describe your pain

Wong-Baker Faces© Pain Rating Scale

The Wong-Baker Faces© Rating Scale shows a series of six faces ranging from a  cheerful face, which means no pain to a tearful face, which means the worst pain ever. The patient picks a face that best relates to their particular pain level. The scale was created for children but is now used for both children and adults. 

Multidimensional pain assessment tools 

Multidimensional pain assessment tools provide more detailed information about your pain. These tools assess pain intensity, your ability to function on a day-to-day basis and the impact of pain on your quality of life. They also track your pain over time and provide insight into whether specific therapies are working. Examples include the Brief Pain Inventory (BPI) Short Form and McGill Pain Questionnaire (MPQ).

Brief Pain Inventory (BPI) Short Form 

In the Brief Pain Inventory (BPI) Short Form, the patient rates their specific pain severity. The BPI also includes a body diagram so patients can indicate where they are hurting. Furthermore, the BPI Short Form dives deeper into questions about how pain affects your life. For example, it includes questions about activity, mobility, your ability to function at work or home, your relationships, medications and quality of life.   

McGill Pain Questionnaire (MPQ)

The McGill Pain Questionnaire is divided into three sections. It consists of 78 words. Each word corresponds with a score ranging from 0 (no pain at all) to 78 (absolutely unbearable pain). Your doctor then calculates an overall pain score.

Body Diagrams or Pain Drawings Of A Human Figure 

Body Diagrams are helpful visual communication tools that allow you to pinpoint the location of your pain. For example, during the Clearing intake process, you simply mark the areas that are hurting on the human figure.

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Pain diaries 

Whether you are meeting with your doctor for the first time or going for a follow-up visit, a pain diary is an invaluable pain tracking tool. There are no hard and fast rules for keeping a pain diary, but it is beneficial to write at least once a day, if not more. 

Daily tracking of your pain can provide insightful information for both you and your doctor. Over time, it may bring to light specific pain trends. You will also learn to identify particular pain triggers. 

Additionally, a pain diary helps track whether various medications, procedures, or therapies are effective. All of this information is useful in developing a strategic pain management plan.

You can customize your pain diary to include different sections. Feel free to get creative. For example, if you want to draw an interpretive picture of your pain, go for it! 

Below are some suggestions on what to include in your pain diary: 

  • The location of the pain
  • The quality of your pain (agonizing, constant, cramping, tingling, etc.)
  • The duration of the pain
  • Medications you took
  • Whether or not the medications helped
  • Whether or not you had any side effects
  • Note anything that made the pain worse or that alleviated the pain
  • Notes on whether you were able to work, drive, or do household chores
  • Descriptions of your mood
  • Any feelings of anxiety or depression
  • Your energy levels throughout the day
  • Ratings of your appetite
  • Any exercise or physical activity you did
  • Your sleep duration and quality

Some patients prefer using electronic diaries instead of handwritten ones. Either way, when you rely on your memory to make diary entries, try to be precise even though you may not remember all the details of your pain. 

Of course, missed entries happen sometimes, or you just don’t feel like making an entry. Whether you prefer electronic journals or good old-fashioned pen and paper, the overall benefits remain the same.

Your doctor may use a variety of pain measurement and tracking tools to understand your pain better. For you as the patient, these tools can also help you navigate your pain journey. 

For example, your pain diary is the perfect place to freely express thoughts and feelings on how chronic pain impacts your life. Some days, you may just want to vent about all the adversities you face living with chronic pain. 

On the other hand, your pain diary may also illuminate positive aspects of your life or show you when your treatments are proving effective. The simple act of writing about your pain can be a very powerful self-healing tool.

So how will pain measurement and tracking be useful for you? 

Since pain is such a personal experience, pain measurement tools serve as the bridge between how you’re feeling and your doctor’s understanding of the pain. Tracking how you’re feeling over time is critical for gauging your general wellbeing and determining whether your treatment plan is working.

So next time you’re due for a doctor’s visit, whether in-person or virtually, you won’t be caught off-guard if you’re asked to fill out a pain scale. And if you’re up for it, you may even opt to share pieces of your pain dairy with your doctor! 

Many thanks to Parcilla Badhwar PharmD, a pediatric pharmacist, musician and pain advocate in Austin, Texas, for partnering with the Clearing team on this article.

This article is for informational purposes only and does not constitute professional medical advice. Always seek the advice of your healthcare professional with any questions or concerns you may have regarding your individual needs and medical conditions.