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The Jones-Davis
Pain Scale:

Pain Assessment Scale Chart showing faces ranging from happy to in pain and numbers with descriptions of what that pain level is.

​The Jones-Davis Pain Scale

  • Pain of  0                                       No Discomfort

  • Pain of  1                                       Slight Discomfort

  • Pain of  2                                       Discomfort starts to change to pain

  • Pain of  3                                       Slight pain

  • Pain of  4                                       Pain starts being uncomfortable

  • Pain of  5                                       Bearable but uncomfortable pain

  • Pain of  6                                       Pain that inhibits use

  • Pain of  7                                       Pain radiates to surrounding area

  • Pain of  8                                       Pain that makes you tense muscles

  • Pain of  9                                       Pain that makes you clench

  • Pain of  10                                     Pain that makes you pull away

Rate your pain on a scale of one to ten. 



Last week you were in here with a ten, but now you say it's worse. A ten is the worst pain imaginable. 


Can you give me an example? 


Like you've snapped a bone in two. 


What if you got hit by a car and broke every bone in your body? I can always imagine worse.


That's not how it works. That's just... 


Arbitrary. Like your terrible pain scale. You can't even comprehend the pain that I've experienced in my life. I've lived through pain that makes breaking a bone a 2 on your pain scale. 


Well, there isn't a better pain scale, so... 


Jones Davis pain scale for one. It was first developed for NMTs so they don't flare up their client's sympathetic nervous system.


What's better about it? 


Well, first it has more precise descriptions of the pain levels, and then pain levels 6 through 10 aren't based on the client's personal perception, which can change, but off of observable nervous system response. 


I don't know about this. 


Now numbers seven through ten required the neuromuscular therapist to apply pressure to the area to see the nervous system response. So if you apply pressure, it's a seven if that pain radiates to the surrounding area. 


This makes a ten way too low. We wouldn't be able to differentiate what's important. 


Okay, so what's a pain chart for? 


Well, it's so we can gauge, how serious is it. 


Because the way it's often been used with me is it tells the medical professional whether or not they should take me seriously.


And even then, when I've said it is a 10, many medical professionals dismiss me anyway. Assuming I'm exaggerating. This chart makes it harder for medical professionals to gaslight patients and belittle our pain, because the pain is really about how the nervous system is responding. That's what's important.


What does the nervous system have to do with...


That you don't know this is... Any pain above a seven on this pain scale is activating the patient's fight or flight response. In fight or flight the sympathetic nervous system is activated, and you should know that if we're in the sympathetic nervous system, we are not in the parasympathetic nervous system. And the parasympathetic nervous system is what handles healing in the body. So if the sympathetic nervous system is activated because of pain, the parasympathetic nervous system cannot heal the body. So prolonged activation of the sympathetic nervous system can cause inflammation, ischemia, deafferentation... 


Am I supposed to care what those are or...?

So when a patient exhibits the physiological pain response of an 8, 9, or 10 on this pain scale, they're in a state where they're not able to effectively and quickly heal. That's when the pain needs to be treated so that the nervous system can go back to the parasympathetic state and can naturally heal the body. So any severity and pain that is above a seven on this pain scale is in many regards irrelevant. 

Your chart still sets the pain threshold too low. See if it were valid other medical...

See what's interesting is the Department of Defense independently developed their own pain chart that overlays the Jones-Davis chart almost perfectly. Though they still rely on the patient's perception rather than an autonomic nervous system response to gauge the pain level, the military came to the same conclusion that the pain chart needed updated with better specificity and a lower pain threshold to effectively treat people. So maybe civilian medicine should take notice.

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