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This afternoon I gave a presentation of my Probaway Pain Scale to several pain professionals. It brought about a lively conversation that made it more apparent that the scale as presented was good for some types of pain and not so good for others. For a person with a recent physical injury, say a muscle injury or a hard knock, to someone age 10 to 60, it was a reasonable measure of pain. However, for a younger or older person even a physical injury has complicating features. The younger people will heal more quickly, and the older ones will heal more slowly or not at all. Another complicating factor is the psychological response to pain. Some people will suppress their response to pain at first only to have it rebound as a chronic pain, while some others will pay close attention to the pain from the onset of symptoms and train their attention to amplify their minds’ response to it. The pain may be real, in the sense that their brain has an observable MRI and fMRI response, where there is no observable physical injury present.

Probaway Pain Scale

Pain Scale – For measuring intensity of human pain – click to enlarge

Some of the professionals liked the linking of each of these pain levels to specified observable symptoms, such as this scale, but others preferred their patients to specify a number 1 to 10 at a first meeting and then specify how much numerical improvement or not, at later meetings. We discussed the value of having defined set points for the numbers versus generalized patient-defined responses. Some patients would be overwhelmed by too much information, as presented in this chart. My opinion was that a patient didn’t need to know the whole thing, but to just have the practitioner observe an apparent condition, for example a PAINS~7, and ask bracketing questions like, “Can you do your daily chores without much difficulty? Or, is your pain so bad you can only do large activities like vacuuming or washing dishes?” Those questions, a PAINS~6 and a PAINS~8, would bracket the person at a PAINS~7, and they need have no knowledge of the overall rating system.

This pain-measuring system would work with chronic pain manifesting at a given time, but that type of pain varies over time in a nonlinear way; it comes and goes. However, even with intermittent pain it would be possible to compare a felt pain from one month to another, whereas a simple choice from 1 to 10 would be more variable over an extended time.

Previous posts:

Measuring Pain in old people.
Measuring pain in old dying people
Pain Scale for Intensity Measurement and Management
The measured pain level varies with the injury type
The Pain Scale for measuring suffering and alleviation of suffering.

Measuring pain so it can be treated more effectively.