How Pain Affects the Body and Mind?

Pain triggers a complex response that involves:

The nervous system, which sends pain signals to the brain¹

The immune system, which reacts to injury or inflammation²

The emotional center, which can lead to stress, anxiety, Depression³

Impact of Inappropriately managed pain

Untreated pain has a profound impact on quality of life⁴

Physical Consequences

Psychological Consequences

Social Consequences

Economic Consequences

Clinical outcomes of untreated postoperative pain include

Atelectasis⁴

Respiratory infection⁴

Myocardial ischemia infarct or Cardiac failure⁴

Thromboembolic disease⁴

Common sequelae of untreated chronic pain

Decreased mobility⁴

Impaired immunity⁴

Decreased concentration⁴

Anorexia⁴

sleep disturbances⁴

Social isolation⁴

Depression or anxiety⁴

Financial burdens of untreated chronic pain

Absenteeism⁴

Income loss⁴

Healthcare costs⁴

workers compensation⁴

Pain intensity rating scales

The Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and Faces Pain Scale-Revised (FPS-R) are among the most common measures of pain intensity used by clinicians and researchers.⁵

Visual Analogue Scale (VAS)

A Visual Analogue Scale (VAS) is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured.⁶

The patient marks on the line the point that they feel represents their perception of their current state.⁶

The VAS score is determined by measuring in millimetres from the left hand end of the line to the point that the patient marks.⁶

Numerical Rating Scale (NRS)

The numeric rating scale (NRS) is a pain screening tool, commonly used to assess pain severity at that moment in time using a 0–10 scale, with zero meaning “no pain” and 10 meaning “the worst pain imaginable”⁷

The patient is asked to make three pain ratings, corresponding to current, best and worst pain experienced over the past 24 hours.⁸

The average of the 3 ratings was used to represent the patient’s level of pain over the previous 24 hours.⁸

Verbal Rating Scale (VRS)

The Verbal Rating Scale consists of a list of adjectives describing different levels of pain intensity. Patients are asked to select the adjective that best represents their pain. This should reflect the extremes of this dimension; from ‘no pain’ to ‘extremely intense pain’ ⁹

Choose below the level of pain you are experiencing

0. no pain or discomfort;
1. mild pain: feeling pain, but no oral medication (analgesic) is required;
2. moderate pain: feeling pain, but no oral medication (analgesic) is required;
3. Severe pain: feeling pain and is no longer able to perform any type of activity feeling the need to lie down and rest (analgesics have little or no effect on pain relief).

Faces Pain Scale-Revised (FPS-R)

The Faces Pain Scale – Revised (FPS-R) is a self-report measure of pain intensity developed for children.¹¹

When should patients seek medical help?

Consider Seeing a Healthcare Provider if you have:

Persistent pain that lasts longer than a few weeks or reoccurs ¹²
Severe pain that interferes with your daily activities, sleep, or quality of life.¹²
Unexplained or unusual pain with no obvious cause ¹²
Changes in existing pain, such as increased intensity or frequency ¹²

References

National Vulvodynia Association (NVA). How We Feel Pain. Available at: https://www.nva.org/learnpatient/how-we-feel-pain/ ; Last accessed 28.5.2025
Boston Children’s Hospital. Pain neurons activate immune cells, opening new treatment possibilities. Available at: https://answers.childrenshospital.org/neurons-pain-and-inflammation/ ;last accessed 28.12.2025
Neugebauer V. Amygdala physiology in pain. InHandbook of behavioral neuroscience 2020 Jan 1 (Vol. 26, pp. 101-113). Elsevier. Available at: https://www.sciencedirect.com/science/chapter/handbook/abs/pii/B9780128151341000040?via%3Dihub
King NB, Fraser V. Untreated pain, narcotics regulation, and global health ideologies. PLoS medicine. 2013 Apr 2;10(4):e1001411.
Alexandra FV, Luís PR, Jensen Mark P. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404.
UF Health. Visual Analogue Scale (VAS).Available at: https://pami.emergency.med.jax.ufl.edu/files/2015/03/Visual-Analog-Scale-VAS-in-depth.pdf ; Last accessed 28.5.2025
Nugent SM, Lovejoy TI, Shull S, Dobscha SK, Morasco BJ. Associations of pain numeric rating scale scores collected during usual care with research administered patient reported pain outcomes. Pain Medicine. 2021 Oct 1;22(10):2235-41.
UF Health. Numerical Rating Scale (NRS) .Available at:https://pami.emergency.med.jax.ufl.edu/files/2015/02/Numeric-Pain-Rating-Scale-Instructions.pdf; Last accessed 28.12.2025
British pain society. Pain Scales .Available at: https://www.britishpainsociety.org/static/uploads/resources/files/Outcome_Measures_January_2019.pdf#:~:text=Verbal%20Rating%20Scale%20(VRS)%20The%20Verbal%20Rating,the%20adjective%20that%20best%20represents%20their%20pain.; Last accessed 28.12.2025
Relvas JB, Bastos MM, Marques AA, Garrido AD, Sponchiado EC. Assessment of postoperative pain after reciprocating or rotary NiTi instrumentation of root canals: a randomized, controlled clinical trial. Clinical oral investigations. 2016 Nov;20:1987-93.
International association for the study of pain (IASP). The Faces Pain Scale – Revised.Available at: https://www.iasp-pain.org/resources/faces-pain-scale-revised/; Last accessed 28.12.2025
Mercyone. Pain Management. Available at: https://www.mercyone.org/blog-articles/pain-management-101-when-self-treat-see-your-doctor-or-consult-pain-specialist ;Last accessed 28.12.2025

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