Rating Your Pain: The Visual Analog Scale

Visual Analog Scale (VAS), Source: Yale.edu

​You have probably been asked by a doctor to “rate your pain on a scale of 0-10” before. The Visual Analog Scale (VAS) is a tool to track trends in your pain level. It can be difficult to know how to put your pain into a number, but doing so can show a clearer picture of what you’re dealing with and how to treat it. It can also show how your pain may change throughout the day, months, or year.  Because of that, it is very important for you to be as accurate as possible in converting your pain into a number on the pain scale.
 

 
Try to think of the numbers on pain scale as the only numbers that possibly exist to quantify your pain. If your pain is at a 1 or 2 out of 10, it would mean that you have some pain that is noticeable, but you can generally function somewhat normally and "push through" the pain. Since "10" is the highest number that exists on this scale, your pain level being at a 10 out of 10 would mean you are so incapacitated from your pain that you need to have someone call an ambulance, or that you cannot walk or sit up due to the pain, or that the pain is making you vomit.
 
It is not helpful to rate your pain outside of the 0-10 pain scale, such as saying your pain is “15 out of 10.” While it may seem obvious that you are making the point that your pain is worse than it has ever been, rating your pain above the 0-10 scale will make people think that you are not accurately reporting your pain, or worse -- that you are exaggerating or drug-seeking. This can make you appear not to be believable witness to Social Security.
 
One thing to keep in mind in reporting your pain levels is not to avoid using absolutes like “never” or “always” when talking about your symptoms. Telling a doctor that your pain “never” goes away, for example, may not be accurate. While it may be true that you do always experience some degree of pain, if you are able to explain to the doctor that certain activities can make your pain better or worse it does give the doctor a great deal more information and it also helps you to be more credible.
 
It can be very helpful to describe the pain that you feel in different parts of your body separately and in terms of both what your “average daily” pain is and also what your “worst pain” is. For example, you have lower back pain that you would generally rate as 3 out of 10 on an average day. Sometimes it will go as high as 8 out of 10 on days when you’ve had to be on your feet longer than normal or when you’ve been engaging in a lot of activity. Keep track of anything that will help to reduce your pain, even if it does not make the pain go away entirely. If things like taking a hot bath, sitting in a recliner with your legs elevated, or taking pain medication does help your pain level to subside somewhat, try to think about how you would rate your pain after doing these things and to put that into a number that might be different from your worst pain.

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