How to Use the Pain Level Chart

What Is a Pain Level Chart?

Some things are very hard to quantify. This holds true even in the health sciences. Pain is one of those elusive factors that evades easy numerical classification. Yet, it is one of the most important sources of data for doctors and other healthcare professionals. A pain level chart provides a useful solution to this quantification quandary. There are several aspects of it that doctors and patients can put to good use.

Where the Pain Level Chart Originated

In the mid-1980’s, a pediatric nurse consultant and a child life specialist saw the need to better understand how patients were feeling when it came to the amount of pain they were experiencing. ¹ The Wong-Baker FACES Pain Rating Scale was soon born. The fact that this was invented in a pediatric setting is not surprising, particularly because children often lack the complex vocabulary needed to describe their pain, especially when they are experiencing it.

How it Works: The Numbers

The pain level chart begins at 0 and ends at 10. If a patient says the pain is at a 0, that means he or she feels no pain. Correspondingly, a 10 indicates the patient is undergoing the worst possible pain. Five, in the middle, is moderate, and the patient reports their level of discomfort proportionately anywhere between 0 and 10.

How it Works: The Faces

Sometimes, for various reasons, a patient isn’t able to verbally express how much pain he or she is experiencing. The Wong-Baker scale, therefore, has a series of faces that allow a medical professional to look at the face of the patient and ascertain approximately how much pain he feels. The primary differentiating factor between each of the faces in the shape of the mouth. At 0, the mouth is in a full smile. As the pain gets worse, it goes to a neutral, flat look and then into a grimacing frown. The eyebrows and eyes likewise change as the pain intensifies, and at the highest levels of pain, 9-10, there are tears. The faces are grouped according to basic classifications as well. 1-2 is labeled “mild,” 3-6 is labeled “moderate,” and 7-10 is classified as “severe.” The faces are grouped accordingly as well.

How it Works: Activity Tolerance Scale

Not only does the pain assessment tool use numerical cues provided verbally and facial expressions, it also has an activity tolerance scale. ² Even though the word choice changes from chart to chart, the basic levels go as follows: no pain → can be ignored → interferes with tasks → interferes with concentration → interferes with basic needs → bed rest required. This is useful because the level of pain can be diagnosed over the phone, through email, or through some other kind of communication that requires a third party.

A pain level chart can also be useful in corroborating expressions of pain to verify their accuracy. Some people like to try to be “tough” when undergoing pain and will under-report. ³ However, if what they say doesn’t line up with their facial expressions or their level of activity tolerance, this can be noted and appropriate steps can be taken. Regardless of how it is used, the pain level chart is a powerful tool in the quantification of something that was once unquantifiable.

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