How Should You Rate Pain From 0 to 10?

The 0 to 10 numeric rating scale asks you to rate your pain from 0 (no pain) to 10 (the worst pain imaginable). It’s the most widely used pain measure in clinics and research because it’s quick and works in conversation, on paper, or in an app. The number means most when you rate the same way each time and compare it with your own earlier ratings, rather than with anyone else’s.

This article is general information, not medical advice. Get urgent help for sudden severe pain, chest pain, or pain with fever, weakness, or numbness.

How the Scale Works

You choose the whole number that best describes your pain’s intensity, often over a stated period such as “right now” or “on average over the last 24 hours”. In their review of adult pain measures for the American College of Rheumatology, Hawker and colleagues describe the numeric rating scale as valid, reliable, and easy to use, with its common bands:

Rating	Common description
0	No pain
1 to 3	Mild pain
4 to 6	Moderate pain
7 to 10	Severe pain

Making Your Ratings Consistent

• Pick one question and keep to it: pain right now, or your worst or average pain in the last day.
• Rate at the same times, such as morning and evening, since pain often varies over a day.
• Anchor the ends. Think of 10 as truly the worst pain you can imagine, not the worst you’ve had this week, or there’s nowhere to go on a bad day.
• Rate intensity, not distress or disability. How much pain stops you doing things is worth noting too, but separately.

What Size of Change Matters

In a study of 2,724 people with chronic pain in trials of a pain medicine, Farrar and colleagues found that a reduction of about 2 points, or about 30%, matched what people themselves described as a meaningful improvement. So a fall from 6 to 5 may be noise, while 6 to 4 is a change worth noticing.

Keeping a Useful Record

Bring a record to appointments: your ratings over time, what you were doing, any medicines with their times, and what helped or made it worse. A weekly average shows trends that a single bad day can hide.

Following It in Kaizora

Pain Intensity is on the Symptoms page, rated from 0 to 10 with Log, with a note for where it hurts and what you were doing. It’s averaged, so a week’s value is the average of its ratings. On Correlations, put it beside Total Sleep Time, Step Count, or Mood by day to see what moves together; the Timeline shows each rating beside the rest of that day.

The Short Version

• Rate pain from 0 (none) to 10 (worst imaginable), the same way each time.
• 1 to 3 is commonly called mild, 4 to 6 moderate, and 7 to 10 severe.
• A fall of about 2 points, or 30%, is a meaningful improvement for most people with chronic pain.

Sources

• Hawker GA et al., “Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP),” Arthritis Care & Research 63, suppl. 11 (2011). doi:10.1002/acr.20543
• Farrar JT et al., “Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale,” Pain 94, no. 2 (2001): 149–158. doi:10.1016/S0304-3959(01)00349-9