Pain is a frequent problem linked to musculoskeletal complaints and is one of the main reasons we stop or modify our activities. It can create feelings of frustration and fear and whilst it is influenced by tissue damage, it is also heavily linked to feelings such as stress and disappointment.
This is why it is important to track and record regular pain scores as we move through the rehab process. It helps to bring objectivity to what is ultimately a subjective experience and it highlights whether the intervention is having a meaningful change in your condition. Tracking our pain can also highlight areas where we need to spend more time before moving on to the next stage of rehab.
Bringing Objectivity to Subjectivity
Have you ever been for a run and felt like you’d given Usain Bolt a run for his money but actually recorded a slower time than a day where you felt like you were running with weights in your shoes? It goes to show that how we feel about performance doesn’t always correlate with how we are actually performing. It is the same when recovering from an injury. Pain is a very subjective thing. We will never know how another person experiences pain and our rating of it depends on lots of factors. By trying to translate those subjective feelings of pain into a numerical value we can start to bring a level of objectivity that enables us to review our progress over time.
If you have had an injury before you’ll know the joy of feeling you are getting better and also the frustrations of feeling like the progress is too slow. In these moments it’s easy to think “this isn’t working!”. But looking back at your pain scales can help to take you out of this subjective moment. You might think “my pain is a 6/10 today and it was only 4/10 yesterday so I’m going backwards”. But then you see that your pain was 9/10 when you began the rehab journey and you weren’t even that active at that point. Now you are more active and your pain is 30% lower than when you started. So the comparison enables you to get perspective and recognise your progress over time.
The Numeric Pain Rating Scale
In the Optimi app we use the Numeric Pain Rating scale so you can track your pain progress. We use this tool because it is super quick, super easy and is backed by research, showing it’s both reliable and valid in measuring improvements in pain.
We use a simple scale from 0 to 10, where 0 represents ‘no pain at all’ and 10 represents ‘the worst pain possible’. Changes in pain scores of 1.5 points indicate a small meaningful change, 3.0 points is a medium meaningful change and 3.5+ points is a large meaningful change.
When performing rehabilitation exercises, it is ok to experience small amounts of pain as you work through your recovery or management programme. However 5 or above suggests you are pushing too hard and should ease off.
It’s important not to try and exercise with significant amounts of pain. If we see you overdoing it, we’ll give you a nudge to remind you to take a step back.