Pain Scale Tests – Part Two

Posted on Friday, May 7th, 2021 at 12:12 pm    

This is the second part of our discussion on the use of pain scale tests in North Carolina and Virginia workers’ compensation cases. As a reminder, pain scales are a way that doctors and others interested in your workers’ compensation case try to measure your pain. The results of pain scales test can affect your right to continued treatment and other work injury rights, such as pain management treatment.  

Pain scale tests are “self-reporting.” This means they’re easy to administer and are generally clerical in nature. Most patients just use a pen or marker and respond to questions on a written sheet of paper. The scales can confirm a worker’s injuries. The scales can also help show if a worker isn’t credible. 

The results may be compared to objective tests. The results may also be compared to prior pain scale tests which means workers need to be extra-careful to given honest answers. The doctors and your employer will look for inconsistent answers.

We discussed many of the pain scale tests in part one of this discussion. Here are a few more common pain scale tests.

The McGill Pain Questionnaire

According to Pain Scale, the McGill Pain Questionnaire (MPQ):

  • Is a subjective test that attempts to measure the quality and intensity of your pain.
  • There are three general categories:
    • Sensory. This part of the MPQ focuses on how you feel at this moment – the moment you answer the question. Different descriptors can be used. Points are awarded depending on which descriptor you select.
    • Affective. “Affective descriptors are used to understand how an individual’s pain changes with time.” “The MPQ asks about how alcohol, stimulants, depressants, exercise, and weather affect an individual’s pain levels. It also goes more in-depth to decipher if distraction lessens the pain.”
    • Evaluative. There are six questions such as “What word describes your pain right now?” or “Which word describes your pain at its worst?”. Workers/patients who say mild get one point. Workers who say their pain causes discomfort are assigned two points – and so on.
  • Uses 78 words to describe your pain. Different point values are given to different words.
  • The questions are divided into 20 different categories including:
    • Temporal
    • Spatial
    • Constrictive pressure
    • Thermal
    • Brightness
    • Dullness
    • Tension
    • Autonomic
  • Is used to treat and monitor pain – and for other reason.
  • Was developed at McGill University in Montreal, Canada.

Pain, Enjoyment and General Activity Scale (PEG)

Another common pain scale test is the Pain, Enjoyment and General Activity Scale (PEG). Pain scales are used to help assess the severity of your pain, whether treatments are working, and what types of other treatments may be needed. Pain scales such as the PEG scale are sometimes used to help determine whether you have a permanent impairment and/or whether and how your pain should be categorized according to American Medical Association guidelines.

How does the PEG scale work?

There are three pain-related questions:

  1. What number (a range is given from 0 to 10) describes the intensity of your pain – during the prior week? If you answer 10, you’re stating that you experienced a lot of pain during the period week. A 5 indicates a moderate amount of pain. A 0 means you didn’t experience any pain.
  2. What number describes how much your pain (during the prior week) interfered with your ability to enjoy your life. A high number indicates that the pain prevented you from doing the things you enjoyed such as walking and enjoying your family. A low number indicates minimal or no interference.
  3. What number (again with reference to the prior week) describes how your pain impacted your “general activity.” General activity suggests doing the things you enjoy and also the things you have to do (like taking out the trash or other errands) even if you don’t enjoy them. General activity can also include essential activities like eating and sleeping. Again, 0 indicates no impact while a 10 indicates a major impact.

The test is graded by finding the average – adding up the three numbers and then dividing by three.

The PEG test can be answered in your doctor’s office. The test can also be answered on the phone or at your home. The test can be used at different intervals in your recovery. It can also be used for different types of pain. For example, it can be used to determine how well your physical therapy is going. The PEG test can also be used to help your doctor understand how well any prescribed medications are working.

If the numbers aren’t improving, that suggests the rehabilitation isn’t working. So be careful, the employer will look to see if your physical therapy is helping. If therapy isn’t helping, the employer (or the insurance carrier for the employer) may seek to terminate the therapy.

The pain scores should improve after you take the medication and stay stable as you continue to take the prescribed medications.

North Carolina and Virginia workers’ compensation lawyer Joe Miller has been fighting for injured workers for more than 30 years. He works to verify your medical injuries. He fights to ensure the employer doesn’t terminate your right to medical treatment or work loss benefits before you’re healthy enough to return to work. To speak with an experienced workers’ compensation lawyer, call lawyer Joe Miller, Esq., at 888-667-8295 or fill out my online contact form to schedule an appointment. 

Employees in North Carolina and Virginia can also now fill out our New Electronic Case Review. The link is a new way of communicating with clients that we’re offering – to allow workers to contact us remotely during the pandemic.