Pain Scales

[Katie]

A year or two ago, someone (Justin??) posted a very good pain scale, the old 1-10 one that helped standardize how a person was feeling.

I stopped using that most times, even though it is what most doctors expect because I find it still so subjective. Many people say that their pain is a 9 or 10 daily out of 10. Because it is the worst they have ever experienced, that's how they perceive it to be on the scale. (And it very well may be.) But while doctors use this, I think they also dismiss anyone who says their pain is that bad,, that they are exaggerating.

So I started explaining my pain in terms anyone could more easily understand. Yesterday, after lifting too many things and standing on a tile floor for several hours, my back felt like I had hit my thumb with a hammer. Most days, it is a mild headache type of pain when I overdue it a bit, and it sometimes goes up to a mild toothache.

Now, I've had a horse jump over a frozen creek and land with all his weight with one foot on mine. After an hour or so, when the swelling reached its peak, the pain was pretty extreme , to me an 8 or 9. Right up there with childbirth

But here's an interesting point....I was telling my hubby the other day that I really can't remember how bad my pain was pre-op. I know what I have now doesn't come close, not in the ball park at all. But if I hadn't experienced the much worse stuff, I could never effectively compare the before and current pain. It is wearing; it just plain hurts sometimes. But it is easily controlled with small amounts (to me) of pain medication and exercise, if I take the time to do either.

So does anyone else use a more 'relate-able' example when describing their pain, or do you feel that the 1-10 scale works well for you?

[Justin]

Hey Katie,

Here's the old thread... Pain Scale

I've got to run now.

[KBear]

10 out of 10 to me was after surgery when the good drugs wore off and I literally prayed to die it hurt so bad. I couldn't even talk, just whimpered and wished for more drugs- and my blood pressure went through the roof from the pain, sending me to ICU. That is 10 of 10. Childbirth (without drugs and pitocin induced, I'd say and 8 or 9). It's all relative though, before I had real back pain, I would've told you that my pregnancy back pain was a 8 or 9 and after having real pain, I would now rate the pregnancy back pain a 2 or 3.

[Pbchoclovr]

Worst pain for me was pre-surgery as they were in the middle of diagnosing all my back issues when the meds weren't cutting it and I developed pneumonia. That pain was off the charts... bigger than a 10... more like a 12 or even a 15. NOTHING touched it. Every movement cause excruciating pain. My blood pressure was so high from the pain and fever, that it caused me to be tachicardic. Ended up getting me admitted overnight to the hospital until they could get my blood pressure down. So when I woke up after surgery and they asked me how my pain was on a 10 point scale, I thought this is nothing compared to the pneumonia episode last fall, more like a 7. It gave me a true comparison to how bad the pain could be.

[Katie]

You guys just made me remember the worst pain ever It happened just over a year ago when I had a four level discogram, plus an experimental procedure that involved injecting those same discs with methylene blue dye. The surgeon had heard of it at a conference, and it had worked with some patients in relieving ongoing disc pain.

Unfortunately the cocktail of pain medications that I was given beforehand didn't work at all, and halfway through the injections, the pain set in and lasted for about six hours. It was off the scale...my scale anyway. They were afraid to give me anything else because of the large amounts I took normally, that I would overdose....at that point I wish I would have, just to be put out of my misery. I was terrified to leave the hospital and go back to the hotel, believing that the pain would return. But just before bedtime, it let up and I was fairly comfortable again.

This isn't to scare anyone who is thinking about getting a discogram. Normally, the pain is controlled...I was just one of the unlucky ones. Thanks for the memories, you two

And Justin, thanks for the link. It is a great one.

[Kimberly]

There have been lots of fun times in my life....back injuries/surgeries, "natural" childbirth, getting run over by a car while in a crosswalk (literally....there were tire marks on my pants) and being strapped to the top of a fire truck and driven out of very bumpy mountain bike trail with broken bones but I have yet to rate my pain as a 10 and here's why......

A few years ago my son had a run-in with a pocket knife that cut his finger to the bone and severed his tendon. The ER nurse asked him to rate his pain on a scale from 1-10 (of course) but said it in a way I had not heard it asked before:

NURSE: "Please rate your pain on a scale from 1 to 10 with 1 being no pain at all and 10 being eaten alive by a shark."

I figure there can always be a shark too.

Kimberly

[Cindylou]

This is a good thread. Pain is so subjective, it has to be tricky for doctors and nurses and physical therapists to read between the lines with each patient. I do think what helps each of us, the patients, in determining what number our pain is currently at, is the life experiences we have had with real super high pain. It really helps us pin it down, don't you think? Like each of you have been describing. My crazy, stupid, over-the-top pain where I would have jumped off a cliff if I could have or over-dosed if I had had access to the pills, was not unlike Kathy's, coming out of my sedation from my 3 level lumbar Prodiscs. I was in out of my mind pain. Those first 24 to 48 hours after that surgery were a nightmare. I had kidney stones one time that sent me to the ER, and they were up there pretty close, but I'd still say they were a 9 and my Prodisc surgery was a 10. I really wanted to die after my Prodisc surgery. And I'd probably say 2 of my 3 childbirth experiences with no drugs were a 9. And the only reason not a 10 is probably because I was just in that 10 out of 10 pain longer, after the Prodiscs. CL

[ajj1001]

If you tell someone that childbirth with no pain relief was 8/10 but post ADR surgery with a failed epidural was 10/10 then it really helps them understand just how painful it is. the 1 - 10 scale is normally phrased as '10 being the most pain you have experienced'. not had too many 10's fortunately, I just howl & cry when it's that bad.

[Catherine]

Well you guys have completely scared the **** out of me . I have experienced all kinds of broken bones, corrective surgery on my feet, childbirth, and the ACDF. I suppose the last broken ankle bone episode and the feet surgery were the worst. Well, and the accident breaking ribs and cracking the hip and pelvis was no picnic either. Still haven't got over that . Childbirth and the ACDF, not so bad. Is it the ADR that makes the pain so bad? I keep thinking having screws and rods drilled into my spine isn't going to be pleasant, but I just didn't think it would be any worse than anything else. Am I totally confused on this? Do I need to completely revise my thinking on this? Maybe I should just jump off the bridge now????

Catherine

[Katie]

Oh, no NOOOOOOOOOOO, Catherine! Oh jeez, what have I started!

OK, let's backtrack....everyone, hands up...who had an epidural during & after lumbar surgery? Of those that did, who had really bad pain? And did you have any information about epidurals etc. before surgery so you would have a choice? We don't want the scare the newbie now, do we....?

Here's my side...and remember, you and I and a few others here are horse women, and can handle anything

By the grace of God, I learned about epidurals before my surgery and thankfully had a surgeon who agreed that they were a good idea. If I hadn't gotten one, I'm sure my tale would be similar to KBear's and others, based on my experience with the discogram. But the days immediately after my surgery (L4/5/S1 fusions & involving a significant spondy that needed lots of reworking) were relatively comfortable. I remember wanting to JOG up and down the hospital corridors and washing my clothes in the bathroom sink. The severe pain just never arrived. I dropped from 360 mg of morphine/day down to about 30 mg within a couple of days, and was somewhat uncomfortable but not in agony by any means. (Except for withdrawal....) I had no pain pump, just the occasional pill.

Yes, I had fusion vs an ADR in my lumbar, but I did have an ADR put in my neck at the same time. And that was a non-issue. I had plastic discs (cages) put in my lumbar, but with no hardware, no screws, etc. And I didn't have any donor bone taken from my hip, also a big factor in the pain scenario.

My pain has jumped all over the map with different surgeries/injuries, and most of it was because it wasn't managed well. Because of the high levels of narcotics I'd been taking for years, the doctors were too afraid to give me sufficient medication during and post-op with the other procedures. But with the lumbar surgery, the epidural stopped almost all the pain from even registering in my brain, so I didn't have any 'shock to the system' so to speak. I healed quickly and easily, as did another patient who posted that the epidural she had recently seemed to work just as well as mine.

So take heart that the big nasty bouts of pain that others have unfortunately endured is not a 'given'. Most of us didn't know anything about alternate ways of doing things until it was over and too late. But that's the joy of this forum...we get to spread the 'good word' I really hope this helps!

And to the others who weren't as fortunate, I'm truly sorry for what you had to go through, but am really glad that you have shared your stories so we can discuss these things. (And Cindylou, welcome back! I've missed you!)