How do you rate your migraines?

How I Rate my Migraines

I have a rocky relationship with the pain scale. Though I think it can be a useful tool for communicating my pain level, I’ve come across several problems with it. First is rating my migraines simply on pain levels. I want to rate my attacks based on all the symptoms. I also don’t want to focus so closely on my own pain as that can sometimes magnify it. It may be part of my perfectionist personality, but I constantly re-evaluate what number I attribute to what level of pain and never feel like I get it quite right. This quest seems almost futile when you take into account the pain scale isn’t just for migraine pain, but for all pain. For example, I have no idea how a migraine would compare to childbirth, an often-used comparison. I also find many loopholes that stop me from ever rating a 10/10. For example, if I have what I consider a 10/10 migraine, and then I fall and hit my head, what is my pain level then? You get the picture.

As I explore how I felt about the pain scale, I realize that I am more interested in how the symptoms keep me from my life than how they fit on a universal pain scale. I decided a simpler system that took into account all my symptoms was in order. Here is what I came up with:

1/3: This migraine either resolves easily with medication or is not severe enough to treat. It’s usual symptoms are limited to pain and mild sensory sensitivities. Because the pain isn’t severe, and my other symptoms are mild, I am able to carry on fairly normally. I may choose to limit certain triggering activities to avoid it becoming worse, but otherwise I am not affected significantly.

2/3: This migraine is likely more painful and comes with a few more symptoms like dizziness, fatigue, brain fog and more significant sensory sensitivities. With a 2/3 type I can still “pass” to others as normal with effort. My symptoms are often being held at bay by my medication. I have carried on with duties and responsibilities with a 2/3 but normal activities are more difficult. I can be easily distracted, move slower, and I feel my productivity is compromised. I would likely be limited in doing certain types of movement and would definitely avoid situations that can trigger worse pain if at all possible.

3/3: This migraine has to have one of two elements: severe pain or other severe symptoms. Usually it comes with both, but I’ve had silent attacks that could still be rated at a 3/3 because of vertigo, fatigue or confusion that keeps me in bed or on the couch. This is a migraine that I cannot imagine functioning through, and any time I’ve tried the severity skyrockets. My medicine likely does not touch it until I take repeat doses, if at all. It usually it has to go away on it’s own, and hopefully sooner rather than later!

Having this rating system has helped me to simplify my migraine diary and look clearly at how my migraines are affecting my life. For example, a goal I have is to never go above a 2/3. There have been situations in the past when my specific pain levels have mattered more, but for now this system suits me well. My doctor is happy to work with me, but if she weren’t then I would simply transfer the numbers to the more traditional pain scale when needed. I would definitely recommend thinking about designing your own system customized to your migraine types, goals, and needs.

To start thinking about how you want to rate your migraines, you can use our migraine journal in the tools section.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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