Measuring cancer pain

Doctors measure cancer pain so they can give you the right treatment. This can include asking questions, examining you and rating your pain on a scale.

Assessing cancer pain

Before your doctor or nurse can manage your pain, they will need to ask you questions about the history of your illness and pain. This is called a pain assessment.

This might seem like a lot to deal with if you're in pain at the time. You probably just want them to give you something to relieve the pain immediately and leave you alone.

But it’s extremely important that your doctor or nurse takes the time to look at all aspects of your pain. That way you can get the right treatment. Your family or friends might be able to help if you really don’t feel up to answering questions.

Your doctor or nurse will examine you and possibly arrange some other tests and investigations.

Questions you might get asked

These are some of the types of questions that your doctor or specialist nurse might ask you.

• Where is your pain? Is it in one place or all over your body?
• On a scale of 0 to 10, how much does your pain hurt?
• Does anything that you do help to lessen the pain? For example, changing position, or applying heat or cold?
• What does the pain feel like? For example, stabbing, tingling, aching, burning, throbbing, cramping or shooting?
• How long does the pain last?
• If you’ve had treatment such as chemotherapy or radiotherapy, has the pain got worse or better?
• Do you have any other medical conditions?
• Do you take any medicines to help with your pain? If you do what is it and how much do you take and when?
• Does eating make the pain worse?
• How long is it since you opened your bowels?
• Do you have any problems passing urine?
• Is the pain stopping you from doing certain daily activities such as housework, making a drink, cooking meals seeing people you regularly see or hobbies you enjoy

Pain examinations and tests

Your doctor or nurse will examine you if you are seeing them face to face. Depending on where your pain is, they might:

• feel your tummy(abdominal) area, hips, spine, hands and feet
• feel for swollen lymph nodes under your arms, in your groin or at the base of your neck
• give you an x-ray or blood tests to get more information

Pain scales and diaries

Another way of assessing your pain is to ask you to rate it on a scale.

This could be on a scale of 0 to 10, where 0 means no pain at all and 10 means the worst pain you can imagine. Some hospitals use other pain scales such as a pain scale from 0 to 4. There are several different scales available and example is Wong-Baker FACES pain rating scale. 

Wong-Baker FACES pain rating scale

Your care team might use a pain faces scale. This is a well known series of diagrams ranging from very happy to very unhappy faces. It's called the Wong-Baker FACES pain rating scale. Your care team ask you to pick a face that best describes your pain. This scale was originally created for children from the age of 3 years old. But it's now used in adults who have pain too.

Pain scales can be a very good way of helping people describe pain. Many hospitals and hospices keep these records to refer back to when you have another pain assessment, or if your treatment changes.

Some people find it hard to rate their pain on a pain scale. You can use words like mild, moderate or severe if you find that easier.

Some people keep a pain diary. This is a daily record or report of your pain. You describe things such as:

• where your pain is
• how strong it is, for example you could use a pain scale of 0 to 10
• what you were doing at the time of the pain. Did anything make it worse?
• how many painkillers you have taken that day including your regular or breakthrough pain relief
• if you took additional pain relief did it help ease the pain?
• if you didn't take additional pain relief where you able to manage it another way?

This information can help you and your doctor or nurse assess your pain. It can help them see how well painkillers are working.

Assessing cancer pain again

Pain assessments are useful to see how well painkillers, or other ways of controlling pain, are working.

A pain assessment shouldn’t just be a one off. It is an ongoing way for the team looking after you to make sure you are getting the right medication and support you need.