{"id":5266,"date":"2021-05-03T12:08:48","date_gmt":"2021-05-03T16:08:48","guid":{"rendered":"https:\/\/joemillerinjurylaw.com\/?p=5266"},"modified":"2021-08-23T17:10:29","modified_gmt":"2021-08-23T21:10:29","slug":"pain-scale-tests-part-one","status":"publish","type":"post","link":"https:\/\/joemillerinjurylaw.com\/pain-scale-tests-part-one\/","title":{"rendered":"Pain Scale Tests \u2013 Part One"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">One of the difficulties in <a href=\"https:\/\/joemillerinjurylaw.com\/practice-areas\/workers-compensation\/\">workers\u2019 compensation<\/a> cases is trying to measure the worker\u2019s pain. Many parts of a medical diagnosis are objective. Disorders can be seen on X-Rays, CT scans, and MRIs. Diseases and other medical problems can be seen when doctors read blood test and other lab test results like stress tests. Medical problems can be confirmed when doctors perform surgeries.<\/span><!--more--><\/p>\n<p><span style=\"font-weight: 400;\">Still, for many types of pain such as chronic pain, the medical disorder is very subjective. In other words, no one except you knows the level of pain that you are feeling on a day-to-day basis. One person may be able to return to work with a severe injury while an employee with a similar injury may need continuing medical rehabilitation or <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/a-glossary-of-pain-management-terms-and-an-explanation-of-neck-pain\/\"><span style=\"font-weight: 400;\">pain management<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To try to fine-tune how much pain a worker is in, physicians and health care providers often use questionnaires and surveys to analyze the degree of pain a worker has. Workers should review with experienced North Carolina and Virginia work injury lawyers how to prepare for and respond to some of these surveys.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are different pain scales for different parts of the body. There are also different pain scales for different injuries and different symptoms.\u00a0<\/span><\/p>\n<h2><b><i>What are the types of pain scales?<\/i><\/b><\/h2>\n<p><a href=\"https:\/\/www.painscale.com\/article\/what-is-a-pain-scale\"><span style=\"font-weight: 400;\">According to Pain Scale<\/span><\/a><span style=\"font-weight: 400;\">, there are two kinds of pain scales &#8211; unidimensional and multidimensional. Some of the common types of scales include the following. These pain scales help when an analysis of pain by objective tests isn\u2019t complete and when pain is expected to vary from patient to patient or worker to worker.<\/span><\/p>\n<p><b>Unidimensional pain scales.<\/b><span style=\"font-weight: 400;\"> These scales focus on the intensity of your pain.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The Visual Analog Pain Scale (VAPS) and the Numeric Rating Scale (NRS) are discussed later (or in the second part of this topic).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A categorical pain scale uses visual or verbal descriptors to help workers and patients focus on the level and degree of their pain.<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Verbal pain scale. The descriptors use words such as \u201cmild,\u201d \u201cmoderate,\u201d \u201csevere,\u201d \u201cdiscomforting,\u201d \u201cdistressing\u201d and excruciating,\u201d to describe pain levels. A worker who takes this type of test chooses the adjective\/word that best corresponds to the intensity of their pain.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Visual pain scale. Here the workers\/patients respond to faces that show the level of pain. While they\u2019re often used for children, adults can use them too.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><b>Multidimensional pain scales.<\/b><span style=\"font-weight: 400;\"> These pain scales are less common but often provide a more complete analysis of your pain. We discuss the McGill pain questionnaire in more detail later. The two other types of multidimensional pain scales are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Initial pain assessment tool. This survey shows a diagram of the human body. The patient marks where their pain is on the diagram, and then <\/span><span style=\"font-weight: 400;\">answers \u201ca series of questions regarding the characteristics of their pain, the expressions of their pain, and the effects of their pain on everyday life.\u201d<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.painscale.com\/article\/the-brief-pain-inventory\"><span style=\"font-weight: 400;\">Brief pain inventory<\/span><\/a><span style=\"font-weight: 400;\">. This test examines the intensity of pain you felt or experienced over the past 24 hours.<\/span><\/li>\n<\/ul>\n<p><b><i>What is the Visual Analog Pain Scale Test?<\/i><\/b><b><i><br \/>\n<\/i><\/b><b><i><br \/>\n<\/i><\/b><span style=\"font-weight: 400;\">VAPS is used for workers and other categories of adults. It tries to measure your level of pain.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The VAPS test, and many other similar tests, usually use a scale from 0 or 1 to 10 or 100. If you have no pain, you enter the lowest number (0 or 1). If your pain is unbearable, you enter the highest number (10 or 100 \u2013 depending on the scale). The VAPS scale is displayed on the written page with a horizontal line for the full scale and vertical lines that correspond to the numbers on the scales.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The VAPS test is simple. There\u2019s just one question and one answer. Workers can either enter a number or just mark the spot on the scale the fits with their amount of pain. For example, if your pain is right in the middle, you\u2019ll answer with a 50 on a 0-100 scale or mark the midpoint of a graph that has the 0 at one end and the highest number at the other end.<\/span><\/p>\n<h2><b><i>What does the score mean?<\/i><\/b><\/h2>\n<p><span style=\"font-weight: 400;\">The VAPS score uses these general guidelines for analyzing the severity of your pain:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">0-4. No pain.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">5-44. Mild pain.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">45-74. Moderate pain.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">75-100. Severe pain.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These classifications make a difference. They can be used to determine:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">What type of medical treatment you require;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">How long you might reasonably need the treatment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Whether you can return to work<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Whether you have a permanent disability.<\/span><\/li>\n<\/ul>\n<h2><b><i>Some of the issues involved with the VAPS scale and other pain scale tests<\/i><\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Workers need to understand that their answer doesn\u2019t exist in a vacuum. Your medical provider will know the results of your imaging tests, lab tests, and any other tests. The doctor will have conducted a physical and oral examination.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If your answer as to your level of pain is not <\/span><b>consistent<\/b><span style=\"font-weight: 400;\"> with other tests and reviews, your answer affects your perceived credibility. On the other hand, everyone has different levels at which they respond to pain. The objective tests are generally given much more weight than the answers to surveys and questionnaires.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Patients need to understand issues such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Am I answering how much pain I have \u2013 when I\u2019m medicated or when I\u2019m not medicated?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Am I answering the question \u2013 just after I\u2019ve had physical therapy or when I haven\u2019t had physical therapy yet?<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Am I answering these questions relative to other types of injuries or just this injury?<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Of course, if your doctor has not ordered the proper kinds of diagnostic testing, then there is no way to match the symptoms to the findings.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For example, if you should have had a lumbar MRI, but your doctor never ordered one, then your doctor may be unaware that you have a severely herniated disc in your lumbar spine from your work injury. This may lead the therapist or Functional Capacity Evaluator to assume you are exaggerating your symptoms (in other words <\/span><b>lying <\/b><span style=\"font-weight: 400;\">to make yourself look worse) and say so in his or her report. We once had this situation.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In this particular case, the <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/functional-capacity-exams-fces-in-north-carolina-and-virginia-workers-compensation\/\"><span style=\"font-weight: 400;\">Functional Capacity Exam<\/span><\/a><span style=\"font-weight: 400;\"> evaluator assumed the client was faking when she said she had severe shooting pains as well as numbness down her leg, and severe back pain. He of course stated there was \u201cno objective testing\u201d to support these severe symptoms, resulting in an opinion that she was \u201cmalingering,\u201d (i.e. faking), which in turn, lead to a very unfavorable report.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Fortunately, the client had health insurance which allowed her to \u201cwork around\u201d her treating doctor and go to a different physician, who ordered a lumbar MRI, which revealed a herniated disc which required surgery. The client was vindicated, underwent surgery and we ended up obtaining a very good settlement for her.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">North Carolina and Virginia workers\u2019 compensation lawyer Joe Miller has helped thousands of injured workers through the work injury claims process. He does more than assert your legal rights and document your injuries. He guides workers through the tests and strategies that insurance companies\u00a0 and employers may use to try to limit or deny your claim. To discuss any questions you have about the workers\u2019 compensation process and to speak with a strong advocate, call lawyer Joe Miller, Esq., at <\/span><b>888-667-8295<\/b><span style=\"font-weight: 400;\">. or use my online <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/contact-us\/\"><span style=\"font-weight: 400;\">contact form<\/span><\/a> <span style=\"font-weight: 400;\">to schedule an appointment.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Employees in North Carolina and Virginia can now fill out our <\/span><a href=\"https:\/\/joemillerinjurylaw.com\/free-workers-comp-case-eval\/\"><span style=\"font-weight: 400;\">New Electronic Case Review<\/span><\/a><span style=\"font-weight: 400;\">. The link is a new way of communicating with clients that we\u2019re offering &#8211; to allow workers to contact us remotely during the pandemic.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the difficulties in workers\u2019 compensation cases is trying to measure the worker\u2019s pain. Many parts of a medical diagnosis are objective. Disorders can be seen on X-Rays, CT scans, and MRIs. Diseases and other medical problems can be seen when doctors read blood test and other lab test results like stress tests. Medical &#8230; <\/p>\n<p class=\"read-more-container\"><a title=\"Pain Scale Tests \u2013 Part One\" class=\"read-more button\" href=\"https:\/\/joemillerinjurylaw.com\/pain-scale-tests-part-one\/#more-5266\" aria-label=\"Read more about Pain Scale Tests \u2013 Part One\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[14,8],"tags":[],"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false},"uagb_author_info":{"display_name":"Joe Miller","author_link":"https:\/\/joemillerinjurylaw.com\/author\/jmiller\/"},"uagb_comment_info":0,"uagb_excerpt":"One of the difficulties in workers\u2019 compensation cases is trying to measure the worker\u2019s pain. Many parts of a medical diagnosis are objective. Disorders can be seen on X-Rays, CT scans, and MRIs. Diseases and other medical problems can be seen when doctors read blood test and other lab test results like stress tests. Medical&hellip;","_links":{"self":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/posts\/5266"}],"collection":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/comments?post=5266"}],"version-history":[{"count":0,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/posts\/5266\/revisions"}],"wp:attachment":[{"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/media?parent=5266"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/categories?post=5266"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/joemillerinjurylaw.com\/wp-json\/wp\/v2\/tags?post=5266"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}