Mankoski Pain Scale
Mankoski devised this pain scale to help describe the subjective
experience of pain in more concrete terms to her doctors and family. Please
feel free to use it and distribute it with attribution.0 – Pain Free
1 – Very minor annoyance – occasional minor twinges.
No medication needed.2 – Minor Annoyance – occasional strong twinges.
No medication needed.3 – Annoying enough to be distracting.
Mild painkillers take care of it. (Aspirin, Ibuprofen.)4 – Can be ignored if you are really involved in your work, but still
distracting.
Mild painkillers remove pain for 3-4 hours.5 – Can’t be ignored for more than 30 minutes.
Mild painkillers ameliorate pain for 3-4 hours.6 – Can’t be ignored for any length of time, but you can still go to work and
participate in social activities.
Stronger painkillers (Codeine, narcotics) reduce pain for 3-4 hours.7 – Makes it difficult to concentrate, interferes with sleep. You can still
function with effort. Stronger painkillers are only partially effective.8 – Physical activity severely limited. You can read and converse with
effort. Nausea and dizziness set in as factors of pain.
Stronger painkillers are minimally effective. Strongest painkillers reduce
pain for 3-4 hours.9 – Unable to speak. Crying out or moaning uncontrollably – near delirium.
Strongest painkillers are only partially effective10 – Unconscious. Pain makes you pass out.
Strongest painkillers are only partially effective.
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Copyright © 1995, 1996 , . Right to copy with attribution
freely granted. The information contained herein written and copyright by
andi@… ( Mankoski)
==========================I’m an 8 most days. Today it’s a heavy 8.
I find there’s too big of a jump from 7-8. It goes from still functional to completely disabled in one number.
I live at an 8, occasionally a 7.5 on a better day, and an 8.5 on days where I freak out my husband so much he threatens to take me to the ER. Occasionally I even reach 9.
Also, people with chronic pain/chronic illness will experience pain differently from someone who is healthy and only occasionally suffers from some sort of low-number acute pain. For example, I have been living at an 8 for two years straight, and then before that a solid 7 for two years, and before that I was in pain too, but it was more manageable (between a 4-6). So, I’ve lived with some level of chronic pain for most of my life and have become accustomed to it, whereas if someone who hardly ever experiences higher-number pain were to suddenly feel what I feel on one of my worst days, they would find it much more jarring and might even number it higher than I did. Similarly, if I’m only experiencing pain at a 6, I’ll ignore it, because my pain level is normally higher than that, but if a healthy person were at a 6 they would already consider themselves to be in a substantial amount of pain.
I also have many different types of pain in my body caused by different things, and they are not all synchronized at the same pain level all the time. I always think of my pains as having auditory volume. Sometimes one pain is loud (let’s estimate an 8) while a different pain I’m experiencing simultaneously is quieter (let’s say a 5). So in my opinion you should always have to specify a pain level for over all pain and then numbers for each individual offender.
I created this pain scale. Back in 1994, when I was using the name Mankoski and living as a female, I wrote this painscale and published it on an early internet-based endometriosis support community. Since then it’s taken on a life of its own. It’s been published countless places both online and in print, been used in academic pain studies and burn units, been refined and shared and branched out to so many places that a web search for “Mankoski” gets my pain scale as the first several hits.
In the twenty years since I wrote it, I’ve made drastic changes in my life, not the least of which is ditching that name and that gender. I still have endometriosis, mostly dormant now thanks to testosterone. And I still have chronic pain.
If I had it to do over, there are changes I’d make to this pain scale. I agree with the comments above that it’s not fine-grained enough between 7 and 8. And I wish I’d called it the McCallum Pain Scale, instead of using my ex-spouse’s name. But I’m still incredibly proud of it. I’m glad it’s something that can help people. And I’m glad that out of my own experience of living with chronic pain and disability, something good has come.
Thank you. I’ve found this immensely helpful, and discussed this a bunch (prolly how you found me) and im kinda honored to play a part in keeping it alive
Kindof a bummer it’s got your old name attached, but i’d be happy to rewrite/edit my posts to include a more accurate attribution.
For me, a usual day is about a 6, and a good day is a three. I do get days below that, but they are rare. Bad days are mostly 7-8, with the occasional 9 where I hope that I can pass out due to the exhaustion of being in that much pain.
This sort of pain scale is valuable because so many of them give you no idea of what level means what. A doctor will say “10 is the worst pain you can imagine” and in comparison people scale things down. So what might have been an 8 gets called a 6 because people have different capacities for imagining pain, I guess. Idk, I had a lot of trouble with it when I had appendicitis.
Now with fibro, I record my pain levels daily. I use this scale to help me work out where I’m at; it’s been very helpful. Again like the above scale it’s not for everyone but it helps me because otherwise I’d have no idea. Most good days for me are a 2, bad days usually a 4 or a 5. I’m lucky. I do get spikes up near a 7 or 8 in particular body parts at particular times, but it rarely lasts more than a couple of hours so I don’t log the entire day at that level.
What’s been interesting for me as my fibro’s been getting worse over the last couple of years is that you really do get used to the pain and what may have been a 3 becomes a 2. So important that healthcare providers understand that when it comes to chronic pain.
Holding the Bowl 