Very helpful Pain Chart

[sunflower]

I know some of us keep symptom journals. I use one of the stool charts in mine, and found this pain chart on another forum. I think this is a very good explanation of what can be described on each pain level. You can repost this elsewhere, leaving the attribution intact.

This pain chart can be of real value to helping set standards for you with your doc...


Mankoski Pain Scale

Andrea Mankoski devised this pain scale to help describe the subjective experience of pain in more concrete terms to her doctors and family. Please feel free to use it and distribute it with attribution.


0 - Pain Free

1 - Very minor annoyance - occasional minor twinges. No medication needed.

2 - Minor Annoyance - occasional strong twinges. No medication needed.

3 - Annoying enough to be distracting. Mild painkillers take care of it. (Aspirin, Ibuprofen.)

4 - Can be ignored if you are really involved in your work, but still distracting. Mild painkillers remove pain for 3-4 hours.

5 - Can't be ignored for more than 30 minutes. Mild painkillers ameliorate pain for 3-4 hours.

6 - Can't be ignored for any length of time, but you can still go to work and participate in social activities. Stronger painkillers (Codeine, narcotics) reduce pain for 3-4 hours.

7 - Makes it difficult to concentrate, interferes with sleep. You can still function with effort. Stronger painkillers are only partially effective.

8 - Physical activity severely limited. You can read and converse with effort. Nausea and dizziness set in as factors of pain.

9 - Unable to speak. Crying out or moaning uncontrollably - near delirium.

10 - Unconscious. Pain makes you pass out.


Copyright © 1995, 1996 , All Rights Reserved. Right to copy with attribution freely granted. The information contained herein written and copyright by [email protected] (Andrea Mankoski)


I personally have been at a 9 and 10 with an obstruction caused by an adhesion. I actually passed out from the pain! The face chart is confusing to me, and the other common one I have seen just doesn't have enough description.

Hope it helps someone!

 

[Nemesia]

Very helpful! Thanks for sharing!

I am at level 6 or 7 since the last 3 months. :-s

 

[Cat-a-Tonic]

Have you seen the "New Pain Chart" from Hyperbole and a Half? It's silly but I love it. Much more useful than those pain charts that are just smiley faces.

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

 

[Grant]

I would say I've been to 9 1/2, verging on passing out because of obstruction. The speed with which it came on left me reeling & I thought my guts were coming apart TBH, so extremely painful & scarey.
Rgds
Grant

 

[JMC]

I don't think I have ever got past a 7 or 8. Definitely never experienced 9 or 10 and I have had an obstruction on two occasions that I can think of. Most days, I would say I am in the 0 to 2 range, so quite lucky.

 

[suschex]

Boy, oh boy have I been wrong about my pain....I was giving it way lower numbers than I should be...pain is such a subjective thing and difficult to describe...glad to have this to help communicate better with my doctor and loved ones...

Thanks for posting!!!!!

 

[aliciars]

I just got out of the hospital from my first obstruction. I told my husband at some point during the chaos --- that if I ever say my pain is a "10", I want to die. When I got into the ER I was exactly what this chart described as a 9. I felt like a wild animal, moaning & vomiting, while writhing around ---- it was nuts.

I felt much better after 3 injections of morphine & zofran. I hope to never see a 9 again. Home now thank God.

 

[sunflower]

aliciars, I have been there too. It was a horrible experience. I actually passed out from the pain, so I guess I was at a 10. It is the in between stuff that is hard to describe. It is very subjective - and those faces are really funny, cat-a-tonic!!

 

[carolhew]

Cat, I love Hyperbole and a Half but I missed this one. It's great, thanks for sharing!

 

[sunflower]

Bumping up for newbies. This is a great chart for keeping a symptom journal. I put a copy of this chart, and the stool chart in my symptom journal. That way, I am consistent on how I describe my stools and my pain.

Then I turn to the post from Hyperbole and a Half and have a good laugh! I may take it to my GI the next time I see him. He may use it with some of his more humorous patients.

 

[scl]

Boy, oh boy have I been wrong about my pain....I was giving it way lower numbers than I should be...pain is such a subjective thing and difficult to describe...glad to have this to help communicate better with my doctor and loved ones...

Thanks for posting!!!!!

Me too. This is so much more helpful that the typical useless chart

 

[tishbite]

7-8 when i'm not taking pain pills. 4-5 when i take my dilaudid. sometime 2-3 (which always is great but never lasts unfortunately)

 

[xX_LittleMissValentine_Xx]

I have never taken pain meds before. But I do have strong pain. I have always felt that I can handle the pain, even if it means I cant keep still.
I also kind of feel that if I start taking pain meds and it makes me feel better then how do I know how well I am?
So I don't really know how to relate to this chart. does it mean my pain has never gone above 4 if I havn't taken anything for it?
And do people think I should be taking pain meds?

 

[DustyKat]

You interpret the chart by the physical symptoms you have and feel regardless of pain killers, they just represent another dimension to help explain pain to a health professional.

I understand the statement you made but I still don't understand why you wouldn't want to feel better. I personally don't see the point in putting up with pain if it is identified and can be treated and given appropriate treatment and pain management most pain can be controlled so that it at least allows you to function. Also bear in mind that pain will stress both your body and mind and that is not a desirable state to be in with CD.

Dusty. xxx

 

[xX_LittleMissValentine_Xx]

Yeah, I understand what you are saying.
I think I havn't taken it before because most of the time my pain doesn't get any higher than 1-2. On the occasions it has been more severe, it usually doesn't last long. Its in situations where I suddenly get a load of pain and then I go to the toilet and it feels better. Or I am starting to get into a flare so I contact my GI and talk to her about things.
But I think I will talk to her about pain meds. I feel my crohn's is changing recently, I am a lot more up and down - not constantly good or bad.
Today I have woken up and my pain is more like 5 or 6, and doesnt seem to be going away. Which is what has made me start to think about pain killers, though I dont know what I should take!
I know I'm lucky that my pain isn't usually very high

 

[DustyKat]

You sound like you are well in tune with your body holly.

I can understand you not taking anything for a 1-2 level of pain and also the more severe pain that you know the cause of and how to relieve it.

You are a sensible and level headed young lady and you have sensed your Crohn's changing. I think you are making the right decision in contacting your GI. :thumleft:

Good luck and let us know how you get on.

Dusty. xxx

 

[scl]

I also find it difficult to rate my pain when it can vary so wildly. For example, during my recent hospitalization for a bowel resection my pain might be a 2 when lying quietly, but would be a 7 if I tried to move at all. What do you answer when faced with that type of situation? For me, it's rarely a single number.

 

[Jessi]

Have you seen the "New Pain Chart" from Hyperbole and a Half? It's silly but I love it. Much more useful than those pain charts that are just smiley faces.

http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html

Laughing my butt off!

 

[DustyKat]

I also find it difficult to rate my pain when it can vary so wildly. For example, during my recent hospitalization for a bowel resection my pain might be a 2 when lying quietly, but would be a 7 if I tried to move at all. What do you answer when faced with that type of situation? For me, it's rarely a single number.

You answer both.

After surgery is it a given that you will experience pain on movement which is why you should give yourself a dose of analgesia about 5 minutes before getting up or early on, even moving slightly in bed, assuming you have a PCA. The pain at rest though is what will help tell them how you are travelling post op.

Outside of surgery it is also important to give the same detail as it can also lead to clues as to what is going on. For example, when my son had his psoas abscess if he laid still with his (R) knee bent his pain was about a 3 but the minute he straightened his leg it shot up to a 9-10. It proved another piece of the puzzle that led to his diagnosis of a perforation and abscess.

Pain is like that, it is fluid, so tell it like it is.

Dusty. xxx

 

[lizzy16]

My pain comes during a bowel movement and can get as high as an 8 (luckily these have been fewer and fewer since starting pred), and then it can sit at about a 5-6 for 20 minutes afterwards before going away until the next BM. This is a helpful chart and has made me realise I'm quite lucky as I'm not in pain all the time and things could be a lot worse. It can be distracting coming back from the bathroom in pain, especially at work, but it's never been necessary to take pain medication as it does go away on its own.

Thanks for posting!