Measuring Pain

The World Health Organization has a "pain ladder" with 3 steps. The steps are mild pain, moderate pain, and severe pain.

• Mild pain: Mild pain is self-limited. It goes away either with no therapy at all or with the use of nonprescription medication such as acetaminophen (Tylenol), aspirin, or other nonsteroidal anti-inflammatory drugs (NSAIDs). There are lots of NSAIDs (examples are Motrin, Advil, and Aleve). Some are available without a prescription. You can try different kinds to find the one that works best for you.
  
  
• Moderate pain: Moderate pain is worse than mild pain. It interferes with function. You may be unable to ignore the pain and go on with all of the activities of daily living, but it goes away after a while and doesn't come back after it has been treated. Moderate pain may need stronger medications than acetaminophen or nonprescription NSAIDs. Most NSAIDs, including ibuprofen (Motrin), have been found to be as effective at relieving pain as codeine. Your doctor can work with you to find the type of NSAID, either prescription or nonprescription, that works best for you.
  
  
• Severe pain: Severe pain is defined as pain that interferes with some or all of the activities of daily living. You may be confined to bed or chair rest because of the severity of the pain. Often, it doesn't go away, and treatment needs to be continuous for days, weeks, months, or years. For severe pain, the World Health Organization recommends strong opioids, such as morphine, oxycodone, hydrocodone, hydromorphone, methadone, or fentanyl, as well as other medications (called adjuvant therapies) as needed for the particular kind of pain. A number of adjuvant therapies are described in the previous section.

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