I’m not pleased with most pain scales I’ve seen out there. Many seem to be for sudden and not chronic pain. So thought I’ll make some for myself, relevant to how I function. They will be for overall pain levels, local pain levels, and headache pain levels. Perhaps they might also be helpful for other people, but mostly they are meant to explain how I myself work, for future reference and for people who are wondering what I mean whenever I start sounding like the Shipping Forecast, going; “Right hip five, stabbing. Left waist seven, constant. Head three and rising slowly.”
Here is a first draft for my pain scales. I have experienced all of these pain levels, and I try to provide examples of what they might be like where I can, but sometimes pain is difficult to explain. I’ll improve them over time, and they might change when/if I keep on experiencing new kinds of pain and reaching new pain levels, but it’s a start.
Note that overall pain levels might be very much lower than any local pain level for parts of me. If for example I have an arm and a leg which are both at five or six temporarily, I might still rate it as an overall four for the day or the moment if I can still function decently. An overall ten would be much, much worse than having just a local ten, even if at those levels I tend to fall unconscious, and that’s probably a good thing.
OVERALL PAIN SCALE
0 – No pain at all. I can barely notice I have a body.
1 – Very light overall pain. I can vaguely notice something being off.
2 – Still very light overall pain. I’m feeling good and ignoring the rest.
3 – Noticeable but still negligible overall pain. Me on a good day.
4 – Uncomfortable overall pain. No longer negligible. Noticeable extra spoon cost for any physical activity. I stop doing unnecessary* things to keep up.
5 – Definitely uncomfortable overall pain. Spoon costs for activity rising. Short term: I will still be able to function decently. Long term: this is where things are no longer sustainable. Might take painmeds if there is anything I really have to do. I’ll start lose sense and perception of time. Short term, I’ll watch Let’s Plays and rest whenever I can.
6 – Slightly distressing overall pain. Normal activity levels no longer possible even in the short term. I go into spoon conservation mode and might stop doing important** but not dangerously important*** things. I will take painmeds if I need to function in the short term. Anything I do will take a much longer time to complete.
7 – Distressing overall pain. I don’t know what to do about myself. If I have painmeds I will eat them, not in order to be able to do things, but just to be able to get some rest and hope that the period of pain will pass quickly. I will still do dangerously important things, but basically nothing else. I might still be able to eat if I have food I’ve already made previous, but it’s uncertain.
8 – Intense overall pain. I’m curled up in bed. Or on the floor. Or anywhere. No normal function possible. I’ll still stubbornly crawl to the bathroom, but the rest of the time will be mostly hibernation and trying to just to survive. Short term and long term, I’ll watch Let’s Plays and spend most of my time asleep or half asleep; just being awake costs too many spoons to be sustainable.
Incredibly Severe Pain
9 – Intense unbearable overall pain. I wish I was dead. I take all the painmeds I can and might even take sedatives in order to just sleep and get away for a few days. I should probably be in a hospital and would be if I thought it would help. If the bills came I wouldn’t be able to pay them. Nothing works.
10 – The pain is literally too severe to stay conscious. The body can’t handle this pain. I’m drifting in and out of consciousness. I am probably in a hospital. I might seriously be dying and I don’t care any more.
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LOCAL PAIN SCALE
0 – No pain at all. I can barely notice this place is a part of my body.
1 – Very light pain. Perhaps a needle prick and quickly passing.
2 – Still very light pain. Like a light bruise or very light stress pain.
3 – Noticeable but still negligible pain. Like bad bruise as long as it’s not touched.
4 – Uncomfortable pain. No longer ignorable. Like a bad bruise when being touched or grabbed. Like sei ping ma, but less fleeting. Noticeable extra spoon cost for any physical activity using this part of the body. I stop doing things using this part of the body if at all possible, but still will if needed.
5 – Definitely uncomfortable pain. Like the tense pain in my shoulders after having being out amongst people for a few hours, but before the arms actually stop functioning. Spoon costs for activity rising for using this part of the body. Might take painmeds if there is anything I really have to do using this body part, but not generally. I might still wince when I need to use it. When the left side of my waist is at five it’s difficult to stand upright. Still something I can easily adapt to by now.
6 – Slightly distressing pain. Like the pain in my shoulders and arms after I’ve been out amongst people long enough for my arms to stop function at all, or like the sudden, stabbing pain which makes me lose all strength in whatever limb it happens to. I will take painmeds if I need to use this body part in the short term, but it might still hurt. Anything I do will take a much longer time to complete. The pain is getting distracting. I might be whimpering and whining. When the left side of my waist is at six I can no longer stand upright for more than a few moments at a time.
7 – Distressing pain. I don’t know what to do. Like the pain in my hip or my waist on an average bad day. If I have painmeds I will eat them, not in order to be able to do things using this body part, but just to be able to rest and hope that the pain will pass quickly. Even if it’s local, I will start being generally crippled by it. I will start injuring other parts of my body in order to be able to avoid using whatever part of me hurts which is all right in the short term but something which has a tendency to really escalate in the long term. Just existing with this level of local pain drains spoons, even when inactive. The pain is getting very distracting. I’m probably literally crying.
8 – Intense pain. Like dislocating a knee and then setting it back together on one’s own without anaesthesia. I’m seriously crippled even when it comes to general life things. If it’s in my arm or leg, I cannot use it even if I might still be able to move it and moving it at all hurts enough to make me cry out. I have no strength in it. Just being in this much pain even locally costs too many spoons to be sustainable in the long term. The pain is extremely distracting and distressing. Life is put on hold.
Incredibly Severe Pain
9 – Intense unbearable pain. Like my ankle when I had twisted it and it had swollen up to the size of a soccer ball and I poked it and literally passed out. I wish I could just cut whatever is hurting away with a chainsaw, even without anesthesia, because it would probably hurt less and be over faster. I take all the painmeds I can and might even take sedatives in order to just try to sleep it off if I know it is a passing kind. I should probably be in a hospital and would be if I thought it would help. I can’t function at all. I might be in too much pain to cry, whine and whimper. I might thrash around or claw silently at walls or in thin air.
10 – The pain is literally too severe to stay conscious. The body can’t handle this pain. Like the pain in my stomach that time I ended up in a wheelchair for a few weeks because I was in so much pain my body could no longer communicate with itself. I’m drifting in and out of consciousness. Even I will call an ambulance at these levels. I am probably in a hospital or at least going there. I might seriously be dying and I wish I am. Anything is better than this pain. I can’t think of anything else than the pain.
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HEADACHE PAIN SCALE
0 – No pain at all. All is great. I’m almost never here.
1 – Light pain in one or two places. No functional difference.
2 – Still light pain. I definitely notice it, but not much functional difference.
3 – I might be slightly distracted and thinking takes longer. Probably not the right time to play a serious match of go.
4 – Distracting pain. Like a light dehydration headache. I will start forgetting things I’m supposed to be doing. My perception of time will suffer.
5 – Very distracting pain. Like a moderate dehydration headache. Reading is getting difficult. I will start zoning out and just stare into empty space. Might still be able to watch Let’s Plays and listen to music.
6 – Slightly distressing pain. A bad dehydration headache or a light migraine. I will begin feeling nauseous and distressed and restless. Watching Let’s Plays or listening to music is getting very difficult, as is everything else.
7 – Distressing pain. I don’t know what to do with myself. A moderate migraine. I will try to avoid doing anything. Any physical activity at all makes it worse. Eating and drinking are difficult, including taking meds. Usually the last point at which I can take meds.
8 – Severely distressing pain. A bad migraine. Eating is impossible and drinking is immensely difficult. Physical activity is out of the question. In some cases I can still take painmeds, but usually at this point it’s too late. I’m feeling very nauseous. I might throw up and sometimes do. Watching Let’s Plays or films is impossible. Music makes it worse. I feel disoriented and dizzy.
Incredibly Severe Pain
9 – Almost as bad as it gets. I can no longer stand light or sound or smells. I hide in the dark and silence. I probably throw up. I can’t do any physical or mental activity at all. I probably cry. I feel like I’m dying.
10 – Unbearable, excruciating pain. A severe migraine, as bad as it gets. I will be crying and clawing wildly around me. I might be drifting in and out of consciousness, but be unable to sleep. I will be throwing up anything I try to eat and drink, including meds. I wish I was dead. I am more or less paralysed from the pain. I will feel cold and shivering. I feel like I’m dying and if I was I would feel no difference. I could probably suffer severe head trauma and not even notice it. I feel numb and dizzy and disoriented for days afterwards.
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* Unnecessary things: Tidying, hobbies, laundry.
** Important things: Getting food and eating it, self-care such as showering. Getting my meds. Taking care of my plants.
*** Dangerously important things: Paying bills to make sure I don’t ruin my economic privileges for all eternity or get evicted or things like that. Taking care of pets.