The Mankoski Pain Scale is the most commonly used one:
Here is a link to it...

http://www.wemsi.org/painscale.html

I think pain is a very subjective thing. Some people can withstand alot of pain, and others cannot.

One can learn to dissociate some pain, through autohypnosis and relaxation techniques. Some research is being done with this type of therapy so that dependence on drugs can be less.

There is a neuronal pathway in the brain that processes pain. And evidence is mounting that it becomes a LEARNED process like other things we learn. So if one allows pain to become your master, it may never go away centrally. The example given is the phantom pain amputees feel, which continues in the brain after the limb is gone. So it is very important NOT to dwell on discomforts, to shift attention and focus elsewhere, so the pain loop does not become permanent.

This is one reason I prefer patches and local pain interventions because stopping the signal at the source seems to prevent future chronic issues. The Lidoderm patches work this way, as well as topical RX creams compounded or OTC like Biofreeze.

I never had a lot of burning. Maybe the bottoms of my feet, back when I was running and thought it was due to that. I have bone pain, and muscle pain. I feel like I may burst out of my skin....like the inner part of me is too big for the outer part of me. I am numb in spots. I do have a muscle like pain or soft tissue pain. I liken my pain to broken bones...like walking on broken foot bones, or having a broken back bone.

Most of my issues are autonomic, with a whole different kind of pain. I can have severe cramping in my intestines which causes me to pass out. (vasovagal with bm) I never know when this will hit....it can come within hours of my just having had my 'daily' since it is unrelated to this.

I feel like I swallowed a bowling ball. I have esophageal spasms that feel like a 'heart attack'. I have nausea and loss of appetite a lot.

I am dizzy, can lose balance, have visual issues, and sicca.

I have a lot of heart palpitations and shortness of breath, and presyncope.

Needless to say, fatigue with the inability to initiate sleep.

I have restless leg.

As was said, pain is relative. The pain I do feel, is 6 to 8, on a daily basis...it is really a bear to move at all....but this is life....it isn't going to change, so I have to use my days as I see fit and fight this miserable pain. Some days are 'good' relatively speaking....which means I can accomplish something despite pain....other days, are not so good, which means I get nothing done but eat pain pills.

Meds designed to make 'things better' can often make things worse. I must be a good part Neanderthal, since I have a lot of issues with drugs, either side effects or them not working well. For example, Zofran, a widely used and thought to be well tolerated drug for nausea, sent me into 8 hours of hideous chorea like dystonia. (Think restless leg syndrome on steroids!!)

Neuropathy can be burning pain of the extremities, but it can be oh, so much more!

I totally agree with MRSD. I have to distract myself from pain. Activity and music help. I always use music when I have a chore I want to do! Music has been found to affect our emotions. I can do so much more when my Ipod is going!

I was taken to the hospital in an ambulance in June with chest pain. Due to family history and my cholerestrol level they ended up doing a cardaic cath. Good news is it wasn't my heart. I also have shortness of breath and dizziness and lose of balance but it is still mild at this point, .i.e. I can still work. The pain is a burning and stabbing pain with cramps in the feet or legs and begining with the arms and hands now. Pain is worse in the evening. Also burning on my back and sometimes my face. Cymbalta keeps the pain in the 5 - 7 range during the day. I talke Lyrica at night to sleep but I have to keep the dosage low or I become non-functional due to side effect. I see the doc next week to explore other meds that might work better as the pain and autonomic symptoms are getting worse. Also trying to get in to see a PN specialist at Johns Hopkins for futher evaluation.

I've always had the philosophy that Pain Hurts

I use cymbalta, zanaflex and neurotin for my pain.

But my primary doctor also told me to make sure I took magnesium that
would help my pain. So I do. I honestly can tell when I haven't
been taking it.

Donna

This is the first I've heard of the Mankoski scale, and I've been researching pain scales on & off for a few years now. It's an ongoing discussion with several of my doctors. Do you have any citations for "most commonly used"? (You know how they love citations!) For a long while, I was promoting the Hochman Pain Scale: (I guess I still do at times.)
http://www.algosresearch.org/Practic...nPainScale.pdf
(only link I could find on short notice)

My doctors hated it. They prefer no benchmarks (as Hochman, Mankoski, and others use) so that patients respond relative to their own histories. They're looking for consistencies/differences within a particular patient's history rather than trying to objectively quantify pain, which I agree is futile for the reasons you state.

I went through self-hypnosis, meditation, and biofeedback for pain. Didn't help because the concentration required was nearly as stressful as the pain, and with severe chronic pain, it's very difficult to keep up for more than short periods.

> There is a neuronal pathway in the brain that processes pain.

In this paragraph, are you talking about the gating theory? I sort of have a handle on it, but still struggling with parts of it.

> So it is very important NOT to dwell on discomforts, to shift attention and focus elsewhere....

I agree wholeheartedly. This is the crux of my presentation on coping with chronic pain. I wrote much of it up and posted to Usenet a few years back, and I'm still getting feedback from folks who are finding it for whom it's been helpful.
http://tinyurl.com/2c642oa

Doc

The pain loop in the brain is quite large, and involves serotonin receptors.

I have seen 2 presentations of it, at seminars, and even then I can't recall many of the details. (none of the doctors there were doing much better either).

It actually involves many tracts and loops down to the spinal cord in the occipital area of the brain, and back up.

This is very complex, and here are some links:
http://www.wellcome.ac.uk/en/pain/mi...science2.html#

http://www.medscape.com/viewarticle/568704_9
(if you don't have a membership to Medscape you can join for free to view this).

It is from studying this pain loop and the receptors present, that leads to using certain SSRI antidepressants to treat chronic pain.

The ideas proposed at the seminars I attend (and the next one will be May 2011) is to intercept the signals so they do not become "learned" and "fixed". Much of it involves attention and focusing on pain, as enhancers of the signals as well. The brain is rather plastic and learns acts over time. We learn language, music, skills this way. Well, the current thought is that pain also can be learned too.

I do my autohypnosis at night in bed, and also during naps-- if I take a nap that is. I feel most of my pain in my feet at night anyway. Dissociating pain, is very difficult when you do a complex motor task like driving. I have not mastered that one.
And it can be dangerous.

The scales are very vague and open to individual variances... since a doctor cannot feel what you feel, some way to describe it has to be used. Maybe some day a tool will be invented by some brilliant biomedical engineer, that will measure pain and that will be a significant improvement in treatment.

a number of years back i posted an article on someone who was advocating for businesses a test he had developed to objectively evaluate pain. It was basically being marketed to fight worker comp cases. I havent seen anything about it since and a search i just did came up with nothing. I guess that never panned out or was a scam.