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Robert Carter posted Jan 25, 2026 2:23 PM

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I work at a long-term drug and alcohol rehabilitation facility. We assess overall pain using a 0-10 Numerical Rating Scale (NRS). We adopted this subjective scale to measure a patients pain experience. This pain scale rating tool is proven to be the best method for our facility.

Nursing will document our patients pain scores at set intervals when they present nursing with pain and vitals and pre- and post-pain intervention. Patients rate their pain on a scale of 0-10 with zero being no pain and ten being the worst pain. In our Electronic Medical Record (EMR) we have dictated pain scores that set off flows based on the scores being above or below a certain number.

I like how the NRS is fast and easy to document, especially how hectic healthcare can be. This also allows you to chart a number and graph it over time to see if interventions are helping. With that being said, there are many limitations to this scale. Patients who are oriented to the pain scale tend to only give three scores: 0,5, or ten. Some cultures are also more expressive with pain than others, which can lead to biased scores (Ball et al., 2022). This tool only addresses pain intensity and does not allow you to get further explanation about pain quality, location, or if it affects daily functions. Also, everyone has a different perception of what a number characterizes; what is a seven to one patient may be a four to another.

To overcome these limitations, we ask all our patients the same questions about their pain when we do their admission assessment, so they understand how to use the scale. We also teach them that we will be asking follow-up questions to better understand their pain. Another thing we do is follow up with the patients by asking them, How is this pain affecting your ability to move, perform activities of daily living, or get sleep. Patient comprehension will be improved by verbal-visual support for the numerical scale expressions and scales utilized (Yeilyurt et al., 2021).

I do like using the NRS as it is a quick way to assess a patient’s pain. But when using this scale, I like to follow up with questions to better understand their pain. In the future, I think there should be more emphasis on pain scales that address pain intensity and functional loss.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2022). Seidel’s guide to physical examination an interprofessional approach (10th ed.). Elsevier.

Yeilyurt, M., Necmettin, & Faydal, S. (2021). Evaluation of patients using numeric pain-rating sc ales.