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Decoding the Arthritis Pain Scale
What kind of pain is it? Describe it on a scale of 1 to 10.
As an arthritis patient, you’ve probably already been asked this by your doctor. You also know how hard it is to answer it.
For starters, it’s the last thing you want to talk about. Pain is an albatross that you have lived with since your diagnosis—you know it’s there, constant, and sometimes, it can be debilitating. Putting a number to it is hard. Describing it for someone who doesn’t experience it firsthand is difficult.
The best way to get the treatment you need is to put these symptoms into words.
The obvious disconnect here is that most doctors, despite their in-depth medical expertise and knowledge about arthritis, have never experienced the pain that patients feel. They have to rely on their patient’s ability to communicate what they’re going through to be able to treat it effectively. If you’re unable to describe it well, your doctor won’t be able to give you your best treatment options.
Not that arthritis patients can be blamed for this either.
Arthritis pain isn’t just about stiff and aching joints. In a lot of cases, it is invisible, and for many, it’s deeply personal.
You can’t simply say, my fingers feel stiff in the morning and call it a day because arthritis pain symptoms will vary from one person to another. It’s hard to put into words the intensity of the pain. Even describing where on your body you experience it can be hard to explain. How do you explain what triggers it when you don’t know, or how long it lasts when you’re unable to predict it yourself? Describe arthritis pain on a scale of 1 to 10? In the context of what? What kind of pain is it? You just know it’s the kind that hurts.
Decoding Arthritis Pain
Understanding your pain scale and explaining it clearly and honestly to your medical team is critical to managing and hopefully minimizing it. In consulting our in-house team of medical doctors and patient network, it was clear that communication is key here. And we hope this guide below will help make it easier to explain it at your next doctor’s appointment.
1. What Kind of Pain Is It?
Arthritic pain is often described as aching and stiff joints. What makes this complicated is that arthritis, especially if it’s the autoimmune kind, tends to be felt along with other pain symptoms.
For example, stiff joints in the morning that feel heavy and dull are typical of RA pain, but it’s often experienced with a sharp, stabbing pain in the joint if you also have osteoarthritis. If it’s throbbing, it mimics gout pain. And if you’re experiencing shooting pain with uncomfortable pins and needles, that’s nerve pain. Sometimes you just feel one in combination with another, other times, you might be going through all of them.
How do you explain it all?
Just tell your doctor.
You’re not imagining the pain. If you’re feeling it, there’s likely a reason why and it’s your doctor’s responsibility to get to the bottom of it all. Don’t mince your words, be as specific as possible. Don’t worry about being perceived as dramatic.
2. Where Are You Experiencing Pain?
The exact location of your pain can be very telling. OA, caused by the natural wear-and-tear of joints, tends to be experienced first in load-bearing joints or joints that we often use, like your knees or hands. RA pain usually starts in small joints such as fingers and wrists and tends to be symmetrical. Other kinds of rheumatic arthritis, such as ankylosing spondylitis is localized to the spine.
There are instances where you can’t even precisely identify exactly where the pain is coming from because it feels widespread beyond just the joints. Don’t worry. Pain varies greatly from one patient to another. If you can’t name the exact joint, point to it and if it feels widespread, trace the path that pain travels to.
3. Explaining Your Personal Pain Threshold
As much as doctors would like to standardize their understanding of arthritis pain (that’s where all the arthritis pain scale questions come in), it can be very difficult to do so because pain is personal.
Let’s start with the fact that patients who suffer from chronic pain perceive pain differently from people who don’t.
If you ask someone with rheumatoid arthritis “how much pain do you usually experience daily,” the most common answer you’ll get is “the usual.” But remember, for any healthy person, the usual is zero pain. For arthritic patients, the usual is pain that lets them still function as close to normal. And even this varies from one patient to another.
For example, let’s say someone with osteoarthritis can function normally at a 3, but if it was an arthritis patient with a more physical job, a 3 would mean reaching for painkillers already. For rheumatic arthritis patients, pain tends to be exacerbated with fatigue as well, and fatigue also affects chronic pain sufferers differently.
To understand your arthritis pain scale, you have to start with knowing your baseline. Maybe your baseline is a 2 and any pain symptoms you’re feeling can be remedied with compression sleeves. Or maybe you’re more resilient to physical pain symptoms but find accompanying arthritis symptoms like fatigue and brain fog more debilitating.
Communicating this to your doctor is essential to understanding your best course of treatment.
4. Is Pain Interfering With Your Daily Routine?
Arthritis, no matter what kind you have, will have a functional impact on your day-to-day lifestyle.
The limitations that you have because of your arthritis tells doctors a lot about how your condition is progressing. Even if you cannot clearly articulate the pain, the changes in function can show your medical team what kind of intervention is needed to help manage your symptoms.
For example, are you able to get out of bed normally? Is it easy for you to get dressed (close buttons, pull zippers, or tie shoes)? Are you able to pick up small items such as coins from a table? Can you easily get in and out of vehicles? Are you still able to regularly engage in social activities? Can you exercise regularly? Can you still do chores around the house? Are you able to climb stairs? How well do you sleep?
These are questions that are easier to describe and quantify and can give more insight into your condition.
5. What—If Anything—Makes You Feel Better?
Be very detailed when you answer this question. What you think may be a negligible piece of information can actually be very telling for your care team.
Is your pain worse in the morning but eases quickly after you move around a bit? Do you feel pain after you eat certain food? Or does it get better? Which medications make a massive difference to your functionality? Is physical pain taking a toll on you emotionally?
These are all things your doctor needs to know and can use to give you the best treatment approach. Depending on your answers, your medication could be bumped up or lowered, changed, or eliminated. Maybe your arthritis is manageable to a point that non-invasive solutions like compression aids and tools are your best bet. If the pain you feel is affecting your mental health, you might need additional treatment to help you manage chronic pain better.
Realistically, it could take a while to find real relief if you suffer chronic joint pain. OA treatments are more straightforward, but other kinds of arthritis may need a bit of trial and error to find the right course of treatment. Being able to communicate your symptoms and understanding the arthritis pain scale can help bring you closer to effective pain and disease management.