Nurses are Masters at the Fine Art of Caring

Vital Signs: Assessing Pain
©2006-Present By Kathy Quan RN BSN
All Rights Reserved
This article first appeared on in 2006

The Fifth Vital Sign
Pain is often called the fifth vital sign. In conjunction with temperature, pulse, blood pressure, pain can reveal a tremendous amount about the health status of a person.
Pain also affects the quality of life through it's affect on such things as mood, activity, appetite, sleep, hygiene, and the ability to focus and concentrate.
Pain Control
To achieve adequate pain control, it is necessary to understand how to assess pain. Pain is totally subjective, and what causes excruciating pain to one person, may only be perceived as moderate pain to someone else.
Assessment Tools
There are several pain assessment tools used by health care professionals to help assess pain levels. These may include the Wong-Baker Faces Pain Rating Scale which depicts several faces from a smiling face representing no pain to a face depicting tears and a scowl representing the worst pain imaginable.
Verbal Pain Scale
A verbal pain scale uses colors from blue to red and a series of vertical lines stretching from blue representing no pain, to deep red representing severe pain.
Numerical Pain Scale
The numerical pain scale, (from Margo McCaffrey RN, MS, FAAN and Chris Pasero RN ,MSNc in their book, Pain Clinical Manual, 2nd edition, 1999, p.63) uses a scale from 0 to 10; where 0 represents no pain and 10 represents the worst pain imaginable.
In addition to the
pain scales, health care professionals will ask questions to determine the quality of the pain and how it affects your functioning. These include:
  • Where is the pain?
  • When did it start?
  • What makes it worse?
  • What helps to ease it?
  • Is it sharp, dull, aching, throbbing, shooting, burning?
How does the pain affect your life:
  • Sleep patterns
  • Eating
  • Activity patterns
  • Your mood and emotions
  • Is it affecting your family?
  • Does the pain affect your physical appearance, your sexual function, your energy levels?
If you are having pain; contact your health care provider and provide information about:
  • the history of your pain
  • the intensity of your pain (using a pain scale)
  • the location of your pain
  • and include information about how it is affecting your quality of life such as activity, mood, sleep and eating patterns, etc.
Pain Medications
It is important to understand that medications will not cure your pain or eliminate it. Medications work in many ways to help ease your pain such as by changing how your brain perceives the pain, by improving your flexibility, by treating underlying factors causing your pain, or by reducing inflammation or swelling. Discuss medications with your health care provider or pharmacist to gain a better understanding of how they control your pain and what to expect from them.