I've given this some thought. That question really doesn't relate to my situation.
1. I have a number of chronic pain issues going on.
2. Any one of them can flare and override others at any time. Headaches generally override/rule, because they're where I live - in my head.
3. My "6" may be (and often is) someone else's "9" or "10" because when it comes to "10" being the "worst pain imaginable" I have a VERY vivid imagination (think "R" rated Vietnam war/graphic Horror movie scenes).

On a really good day (rare), I may record a 4. On an average day, a 6. On a bad/flare day (much more frequent than a good day), 7 or 8. I have only recorded higher than that once, while in an ER. So PN doesn't really enter into my way of thinking about it; it's just another symptom/source of pain.

When I need to take a gabapentin is when I cannot sleep/function without. Even at the low dose I take, the side effects are intolerable to me; it knocks me out for 2-3 days, and I cannot function normally.

Like I said, everyone is different.

Doc

This has been posted before, but it never hurts to 'freshen' memories:

Mankoski Pain Scale
Copyright © 1995, 1996, 1997 Andrea Mankoski. All rights reserved.
Right to copy with attribution freely granted.

0-- Pain Free No medication needed.

1-- Very minor annoyance - occasional minor twinges. No medication needed.

2-- Minor annoyance - occasional strong twinges. No medication needed.

3-- Annoying enough to be distracting. Mild painkillers are effective. (Aspirin, Ibuprofen.)

4 --Can be ignored if you are really involved in your work, but still distracting.
Mild painkillers relieve pain for 3-4 hours.

5-- Can't be ignored for more than 30 minutes.
Mild painkillers reduce pain for 3-4 hours.

6-- Can't be ignored for any length of time, but you can still go to work and participate in social activities.
Stronger painkillers (Codeine, Vicodin) reduce pain for 3-4 hours.

7-- Makes it difficult to concentrate, interferes with sleep You can still function with effort.
Stronger painkillers are only partially effective.
Strongest painkillers relieve pain (Oxycontin, Morphine)

8-- Physical activity severely limited. You can read and converse with effort.
Nausea and dizziness set in as factors of pain.
Stronger painkillers are minimally effective.
Strongest painkillers reduce pain for 3-4 hours.

9-- Unable to speak. Crying out or moaning uncontrollably - near delirium.
Strongest painkillers are only partially effective.

10-- Unconscious. Pain makes you pass out. Strongest painkillers are only partially effective.

Yes, and I've responded with the even better known Hochman Scale, created by an actual PM doctor, rather than a lay person.
http://www.algosresearch.org/Practic...PainScale.html

Our docs - all of them, from all disciplines including PM - don't like either of them (or any of the others I've dug up). I've been having this discussion with them for years, and they've been quite candid about it. They don't want an objective scale nor one with benchmarks; they want a subjective scale compared against each patient over time, because each patient's pain threshhold, tolerance, and perception is unique.

If anyone's docs accept them, great. Personally I haven't met any yet (other than a brief exchange with Dr. Hochman). None of the docs around here do.

I always have such a hard time knowing which is the most accurate answers with those scales. A lot of the time, my pain feels like first degree burns...some would say that's unimaginably horrible, yet others would say it's not bad at all. Like someone said earlier "I can imagine some pretty horrible things" and none of mine is in that category, but it still doesn't mean I don't want it to stop or that it isn't having a profound negative effect on my life.

Let me ask this: what number will get a doctor to believe that your pain should be treated?

How true. Pain is different for everyone. Some people endure much more pain than others and say their pain is less. I have a very high threshold for pain, some people have very low thresholds.

I have headaches all the time, never gone. I go to work with head pain that many would stay in bed with. Movements make me dizzy when the pain is bad and people do not understand this. We have a delivery man that has a clipboard we must sign when he drops off items...he will wiggle it back and forth for my reaction, I just can not convince him it's not funny. If he truly understood what he was doing to me, he wouldn't do it, yet some people just can't fathom what you are going through.

We all have different levels we can handle and these levels can change according to the day. I wish everyone could be painfree, would be so wonderful.
:hug:

The pain scores are relative for each person. Ideally the scores are used as one tool to measure a response to treatment. Regardless of the number, if you are debilitated from the pain you should be treated. The response to treatment is measured by, among other things, your change in pain score coupled with your functional improvement. If your doc isn't doing it this way, try to find another.

Neurontin is titrated in 100 mg increments. Ideally start at 100 mg/day and increase the dosage by 100 mg increments every 2-3 days. You do this until you either get the desired improvements in symptoms or until you experience side effects from the medications. Many people experience sedation, but this can improve over time. Again, not easy to find a doc who will do it this way or knows how to do it this way. Hope that helps