Updated 22 October 2013

Assessment of pain

The experience of pain is different for different people. The best person to assess the patient's pain is the patient him or herself.


Medical staff can often underestimate a patient’s pain. It is important to listen to the patient as his or her assessment of the pain experienced is the most important indicator.

Pain charts:

Doctors have developed many types of pain charts to help them asses how much pain their patients are experiencing. The simplest rating of pain is: mild – moderate – severe.

Also easy to use is a straight line containing numbers from zero to 10. The patient can indicate how severe the pain is by making a mark along the line: zero is no pain, 10 is the worst pain imaginable. This method is also very useful to follow the progress of the pain: the patient makes a mark every six hours or so, which tells the doctor whether the pain therapy is effective or not.

Mild pain corresponds with a score of 0 to 3; moderate pain with a score of 4 to 6 and severe pain with a score of 7 to 10.

Pain can of course also be verbally rated from zero to ten.

For children, a linear scale with smiley faces can be used:

Pain perception versus pain tolerance:

Pain perception is the level at which a person starts finding a stimulus painful. The pain threshold is very similar for different people. For example, most people will experience pain if they touch an object which is hotter than 45ºC.

Pain tolerance is more subjective. It varies greatly from person to person and in the same individual at different times.  

Two people who undergo the same procedure may have very different experiences – for one the pain may be intolerable, while the other may experience it as merely uncomfortable. When a person is tired and irritated as a result of poor sleep, pain is less well tolerated.

 An important part of postoperative pain relief is reassurance and comfort. It is a great help if medical staff can take time to empathise with a patient and offer TLC.

Reviewed by Prof CL Odendal, senior specialist at the department of anaesthesiology at the University of the Free State, April 2010.

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