Alright , Mr smith . Are you in any
pain today ? Huh ? Let's do
this on a 0 to 10 scale . I want to
tell me where your pain is at . Zero ,
meaning no pain at all and 10 being the
most pain you've ever experienced in
your life . This is a numeric rating
scale for pain intensity . These scales
have been the standard in medicine for
measuring pain for decades . This tool
was developed to help medical providers
better understand a patient's pain
intensity level and the changes that
occur after treatments like medications .
However , experts have started to
understand that getting to zero is
frequently not the most important
objective , that addressing physical
function and emotional well being is
often as essential to getting patients
back to active and productive lives .
Many clinicians began to consider that
there might be a need for an improved
tool to guide the conversation and
treatment decisions about pain . These
observations resulted in the
development of the defense and veterans
pain rating scale , or D . V . P . R .
S . At its foundation . The D V . P .
R . S begins with the familiar 0 to 10
method of reporting pain . The D V . P .
R . S also incorporates other visual
cues , including graduated intensity
bars , the green , yellow red color
continuum and a facial pain scale for
those who might have difficulty
communicating . Additionally , the use
of mild moderate and severe pain levels
correspond to the pain intensity ,
colors and bars when using the D . V .
P . R . S . The conversation still
begins with you communicating your pain
level using the visual cues on the 0 to
10 scale , but what's important about
the D . V . P . R . S . Is that the
conversation doesn't stop there . The D .
V . P . R . S . Continues the
assessment beyond pain intensity . An
important evolution in the D . V . P .
R . S . Is the addition of functional
language associated with the 0 to 10
numbers anchoring your pain experience
in terms of how it impacts your level
of function , what your providers call
functional disturbance with the
inclusion of these anchors . Two things
are accomplished first . As you become
familiar with these functional anchors ,
the pain question will have greater
meaning to both you and your providers
and the recorded pain values will have
greater clinical value also by
recalibrating the pain discussion from
intensity alone to one that emphasizes
your function . You and your clinicians
can now discuss pain and measure
success of pain management in the
larger context of what treatments
actually improve your function , thus
reducing the likelihood of medication
centric pain management aimed solely at
getting the pain to zero . Additionally ,
because pain often transcends a simple
measurement of intensity and affects
many areas of your life . The D . V . P .
R . S also includes some additional
questions aimed at providing insight on
the impact of pain in four key areas
activity , sleep , mood and
stress . These questions take only a
few extra seconds to answer , but they
provide important indicators of the
success or failure of pain management
therapies far beyond what is obvious
when only focusing on pain intensity .
It is not uncommon for many people to
remain relatively static with their
pain intensity scores for a period of
time . However , changes can be
observed in the other measures that
indicate improvements in a person's
quality of life , assessing these other
dimensions of pain is critical to your
provider's understanding of how pain
might be affecting your overall well
being and can alert to potential
physical and psychosocial issues
related to your pain . The D . V . P .
R . S can be used whenever pain is
discussed or assessed . It provides
valuable information and insight to
both you and your health care team as
you work together to develop
appropriate treatment plans for
managing your pain .