There is a question I’ve answered more times than I could possibly count:
“What’s your pain from 1–10?”
You’d think I’d be excellent at this by now.
I am not.
Sometimes I’m sitting there thinking:
Define your terms.
Because what exactly are we rating?
The physical sensation?
How much it’s interfering with what I’m doing?
How exhausted I am from dealing with it?
How much I’ve changed my plans?
How much longer I think I can keep doing whatever I’m currently doing?
Because those numbers might be very different.
Pain Has More Than One Dimension
When I say my pain is a certain number, that doesn’t automatically tell you what my day looks like.
I could be hurting and still working.
I could have less intense pain but be completely exhausted.
I could be functioning fairly normally while constantly adjusting how I move.
I could be sitting still and doing okay—but know that standing up and walking around is going to change things.
That’s why sometimes the number feels incomplete.
It answers:
“How much does it hurt?”
But not necessarily:
“What is this doing to your life right now?”
Function and Pain Aren’t Always the Same Number
This is where things get especially complicated.
There have been times when I’ve been able to keep doing what I needed to do while hurting.
That doesn’t mean it was easy.
It means I was functioning while hurting.
There have also been times when something that might sound like a lower number affected what I could realistically accomplish much more than expected.
Pain doesn’t exist in isolation.
There’s fatigue.
Sleep.
Concentration.
Movement.
Stress.
Whatever else my body has going on that day.
It’s all happening at once.
Context Changes the Answer
Imagine two different days.
On one day, I’m home.
I can change positions.
Rest.
Use whatever helps me.
Move at my own pace.
On another day, I have work, errands, appointments and somewhere else I’m expected to be afterward.
Same pain intensity.
Completely different impact.
That’s why context matters.
The Number Still Has a Purpose
I’m not saying we should throw pain scales into the trash.
They can be useful for communicating changes and giving healthcare professionals information.
My issue isn’t that someone asks for a number.
It’s expecting the number to tell the entire story.
Sometimes I need the number and the explanation.
“It’s a 5, but I’m having trouble concentrating.”
“It’s a 6, and standing is making it worse.”
“The pain isn’t terrible right now, but I barely slept because of it.”
Those sentences tell you something the number can’t.
Maybe We Need One More Question
After:
“How bad is your pain?”
I’d love to normalize:
“What is the pain making harder for you today?”
Because the answer might be:
Walking.
Working.
Sleeping.
Thinking.
Driving.
Cooking.
Sitting.
Standing.
Making plans.
Or absolutely nothing at the moment.
That information matters too.
Chronic Pain Is More Than a Number
There are days when I can give you a number immediately.
And there are days when my brain wants to hand you an entire PowerPoint presentation.
Unfortunately nobody requested the presentation.
So I’ll give you the number.
But during Pain Awareness Month, I want to make room for the rest of the answer too.
Because pain isn’t only about how much something hurts.
It’s also about how that pain is affecting the person living with it.
And sometimes?
That takes more than one number to explain.
— Michelle
Radiant Rise
Healing. Growing. Rising Together.
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