The Pain Scale Explained

Throbbing. Piercing. Stabbing. Aching. These words--and a few that are a little more colorful-- are words we use when we’re in pain. While we all understand what these words mean, quantifying their intensity is a little more difficult--even when we are actively experiencing it. 


Pain research is an increasingly valued area of study, and also a bit of a difficult one. Medical professionals have long had the arduous task of not only healing the underlying problem but also individually treating pain based on a unique and personal descriptions from patients. That’s where the pain scale comes in.


The pain scale, which measures discomfort on a range from 0 to 10, is a common tool used by medical professionals to determine pain as it interferes with daily life. A “zero” is perfectly healthy and pain-free. A “ten” is unspeakably painful (and incredibly rare).


“The hardest thing about the pain scale is that, despite giving us a range of numbers, it’s still highly subjective,” said Dr. Hope, award-winning Neurosurgeon based out of the Center for Cranial and Spinal Surgery, in Fairfax, Virginia. “One person’s ‘3’ could be another patient’s ‘7.’”


To better gauge your pain level, and to provide useful information to your doctor, it may help to understand how the pain scale works so that you can best apply it to your situation, your conversation, and your treatment.




0 – No pain with full function.


1 – Pain is present, but you only really notice it when you stop to think about it.


2 – Annoying pain. You may experience stronger, occasional twinges, but you’re able to handle it, and it’s not enough to slow you down.


3 – Pain is becoming distracting. You can work around it, but you may start changing your routine or behavior to find relief.


4 – Moderate pain. You are still able to ignore it for a time, but it eventually builds to a point where you can’t focus on anything else.


5 – Moderately strong pain. This pain can’t be ignored for more than a few minutes, although you can still manage to work and participate with some effort.


6 – Interfering pain. This is pain that takes up a fair amount of space in your thoughts and activities. You may be able to work through it, but it takes concentrated energy, and this means you can’t concentrate on other things. Normal daily activities are not possible.

7 – Dominating pain that takes control of your senses. This level of pain significantly limits your ability to perform normal daily activities, including maintaining social relationships and sleeping.


8 – Intense pain that causes you to catch your breath, stop conversations, and change your breathing patterns.


9 – Excruciating pain. Not only are you unable to converse, but you may also find yourself uncontrollably moaning or crying out unexpectedly.


10 – Unspeakable pain that can lead to delirium and unconsciousness. Thankfully, very few people will ever experience this level.


While pain is subjective, so is “normal”. Our goal at the Center for Cranial and Spinal Surgery is to lower the pain level of every patient to a point when then can resume normal activities, normal relationships, and a normal life--whatever normal is to them.


Take our Neck Disability Index Questionnaire