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The Pain Score

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The Pain Score

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Pain over a score of 4 interferes with daily activities.

Pain over a score of 4 interferes with daily activities.

Pain is typically measured on a scale from 0-? Do you know the answer to this question?

The right answer is 10.

The zero to ten pain intensity scale is the most common method of determining pain intensity or severity. One to three is mild pain, four to six is moderate pain and seven to ten is severe pain. Screening pain scores (a pain intensity rating at the time of patient visit or admission) can be used to get a baseline indication of pain level upon hospital admission or with each ambulatory care visit. Each patient should be assessed for the presence of pain, pain intensity, and barriers to pain assessment. To make the process easier, simple screening questions are used on acute and long-term care admission forms to ask if the pain is present and if so at what intensity, if the patient has any prior problems with pain management, or if the patient has had severe pain for longer than twenty-four hours. If the patient indicates pain or responds positively to these questions, a more detailed and comprehensive pain assessment should be carried out. The use of screening scores for pain assessment has been cited by the Joint Commission as one method of identifying patients with pain.

These pain scores or forms with pain assessments should be entered into the patient’s permanent chart. If the patient has a pain rating of 3 or above on a 0 to 10 scale, there should be a documentation of further assessment questions. Appropriate questions might be; what caused the pain, where is it located, how long has it been present, what has the patient been using for pain relief, how many days of work have been lost? There should also be some written indication of what the cause of the pain might be; tests such as x-rays, CT or MRI scans are ordered if the cause is unclear. The medical plan should include interventions or actions for pain relief. These actions could include pain medications, physical therapy evaluation, or a pain specialist consultation. This intensity scale is used for reassessment after pain medications to indicate how effective the pain medication was for relieving the patient’s pain.

How can plaintiff personal injury attorneys use this? Here’s your practice tip: Have the patient describe the character of the pain. Patients use words such as squeezing, crushing, tightness, cramping, throbbing, shooting, aching, dull, and pulling. Ask the plaintiff to use vivid words. Also, consider having a medical person find the references to pain levels and have them placed on a graph to show the actual values.

Modified from D’Arcy, Y., “Pain Assessment”,  Medical Legal Aspects of Pain and Suffering.

Med League provides an expert witness for Pain and suffering (also called Federal Rule of evidence 1006) cases or other types of healthcare experts. Call us for assistance.

 

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