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Annotated Mankoski pain scale

The first three columns below are copyright © 1995 1996 1997 by Andrea Mankoski, and may be distributed with attribution. The final column is my addition.

(Note: I do not take the specific prescription medications listed in the third column.)

Number Mankoski intrusiveness level Mankoski medication level Personal comments
0 Pain Free No medication needed. Never happens.
1 Very minor annoyance - occasional minor twinges. No medication needed. Never happens.
2 Minor annoyance - occasional strong twinges. No medication needed. Never happens. The last time I had this little pain I was a child.
3 Annoying enough to be distracting Mild painkillers are effective. (Aspirin, Ibuprofen.) Never happens.
4 Can be ignored if you are really involved in your work, but still distracting. Mild painkillers relieve pain for 3-4 hours. Never happens.
5 Can't be ignored for more than 30 minutes. Mild painkillers reduce pain for 3-4 hours. Uncommon. Happens with good luck when workload level and intensity are low. (Hoping for more of this.)
6 Can't be ignored for any length of time, but you can still go to work and participate in social activities. Stronger painkillers (Codeine, Vicodin) reduce pain for 3-4 hours. Very common. I basically live in this zone (with Rx meds) on most of my better days. Brain at >80+% of former glory.
7 Makes it difficult to concentrate, interferes with sleep. You can still function with effort. Stronger painkillers are only partially effective. Strongest painkillers relieve pain (Oxycontin, Morphine) Less common. Happens when typing load cannot be kept low. (Breakthrough Rx meds untouched up to this level.)
8 Physical activity severely limited. You can read and converse with effort. Nausea and dizziness set in as factors of pain. Stronger painkillers are minimally effective. Strongest painkillers reduce pain for 3-4 hours. Rare, if I play my cards right. Still usually happens during part of out-of-town trips.
9 Unable to speak. Crying out or moaning uncontrollably - near delirium. Strongest painkillers are only partially effective. Extremely rare. International long-haul economy flights or blistering migraines will put me there.
10 Unconscious. Pain makes you pass out. Strongest painkillers are only partially effective. Happened once, from gallstones.