“On a scale from 1 to 10, how would you rate your pain?” We hear this question anywhere medical treatments are provided. Pain scales are important tools in medicine for assessing the extent to which pain may be limiting someones ability to work or simply move. However pain at the outset can appear subjective. Once I was in for an exam after a tennis injury and the doctor asked me what pain I felt. I was perplexed. I couldn’t explain it. I just knew the pain in my shoulder was very uncomfortable–and dull, yes that was it. Turns out it was—wait for it—the rotator cuff. The idea that pain is subjective suggests a proper assessment of it requires asking the right questions, using the right adjectives.
In personal injury cases and Workman’s comp cases, pain levels are used to determine compensation amounts for the patient. Early in my interpreting career I was assigned to interpret for injured workers during compensation hearings. I heard things like, impairment rating and extent of injury. These metrics are determined during a Functional Capacity Test (FCE). During this test with a medical examiner specific questions about pain are a major topic.
I’ve interpreted many FCEs for plaintiffs in injured worker cases. Most injuries involve some level of back injury. During one of my first FCEs the patient was a truck driver who, while unloading, was struck with a stack of heavy palettes. The doctor asked, “Is it a tugging pain? Or, is it a wrenching pain?” As she moved her hands around his back. Now, keep in mind she asked the question in English and I interpreted into Spanish. “Is it scalding pain?” What? I was having a hard time, so I asked the doctor where she was getting these adjectives from. “The McGill Pain Questionnaire,” she replied, or also known as MPQ.
I took a short break and found a copy on the internet translated into Spanish. The pain scale was developed in 1971 by Dr. Melzack and Dr. Torgerson at McGill University in Montreal, Canada. Turns out because of it usefulness it has been translated into dozens of languages.
As you work with the scale and if you are new to interpreting FCEs or doing depositions in personal injury cases, you’ll begin to realize there are 3 sections.
All of the sections together use 78 adjectives to describe, how the pain feels right now, how it changes over time, and how strong the pain feels in general, respectively. There are 20 different categories on the MPQ to describe pain. A point value, varying from one to five, is given to each word.
Even as an advanced interpreter, I review the MPQ now and then. Many of the adjectives are not words you use on a daily basis, and usually are not applicable in other interpretation settings. Learning to describe pain accurately is one toolbox you should fill as you begin working more complicated cases.