Which Pain Scale Is Best to Use?

A Closer Look at Qualitative and Quantitative Pain Scales

Measuring Pain
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There is really no answer to which pain scale is best at describing your pain. It’s like asking which color is best, or which worldwide city is best. Different pain scales are just that: different. Some physicians have favorites, while others choose the pain scale based on either your pain condition or on you (for instance, children may need a different type of pain scale than do adults).

Occupational therapists learn to divide pain scales into two types: quantitative and qualitative. More specifically, you can use a quantitative scale to measure pain and a qualitative scale to describe pain. Both types of pain scales have advantages and disadvantages.

Quantitative Pain Scales – When You Need a Pain Number

Quantitative pain scales are used to assign a number or some kind of "marker" to your pain. Some examples include:

Quantitative scales (mostly the numerical pain rating scale) are often used on rehabilitation units to determine whether a pain treatment was effective. For instance, our nurses ask patients to rate their pain before and after taking painkillers. Therapists use them before and after treatments, especially if we are using a pain modality such as TENS or ultrasound. If your pain number or marker stays the same (or if it increases) this means that the treatment wasn’t so helpful. If it goes down, however, the pain treatment is working.

Qualitative Pain Scales – When a Pain Number Isn’t Enough

Sometimes we're not looking for a pain number. We want to know how your pain feels, not how intense it is. Hence, we use qualitative pain scales.

Qualitative pain scales can help us define or classify your pain. For instance, pain that is described as sharp and stabbing may have a different cause than pain that is dull and throbbing.

Therapists don't diagnose pain but can tell patients what class of pain they may be experiencing based on their descriptions. For instance, if a person who has recently undergone neck surgery describes shooting pain from her shoulder down her arm, a therapist can tell her it is likely nerve pain related to her surgery or the condition that led to her surgery. If the patient describes a dull ache in her neck and shoulder muscles, however, a therapist may assume that it is related to muscle fatigue from her therapy exercises.

Hybrid Pain Scales – Combining a Pain Number With a Description

Sometimes, a hybrid scale gives us the best of both worlds. A hybrid scale not only gives us an idea of the type of pain you may have (and how it feels to you) but also how severe the pain is. Hybrid pain scales can be helpful both for diagnosing and treating pain.

View Article Sources
  • Gould, Harry J III. “Understanding Pain: What it is, Why it Happens, and How It’s Managed” New York: American Academics of Neurology 2007