# Mankoski pain scale Developed by Andrea Mankoski, who was living with chronic pain due to endometriosis at the time she created it. Provides more concrete details and a shared communication point to describe pain, which is otherwise quite subjective and can be difficult to describe. | Level | Description | | -------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | 0 – Pain free | | | 1 – Very minor annoyance | - Occasional minor twinges.<br>- No medication needed. | | 2 – Minor annoyance | - Occasional minor twinges.<br>- No medication needed. | | 3 – Annoying enough to be distracting | - Mild painkillers are effective (aspirin, ibuprofen). | | 4 – Can be ignored if you are really involved in your work, but still distracting | - Mild painkillers reduce pain for 3–4 hours. | | 5 – Can't be ignored for more than 30 minutes | - Mild painkillers reduce pain for 3–4 hours. | | 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, acetaminophen-hydrocodone) reduce pain for 3–4 hours. | | 7 – Makes it difficult to concentrate, interferes with sleep | - You can still function with effort.<br>- Stronger painkillers are only partially effective.<br>- Strongest painkillers relieve pain (extended-release form of oxycodone, morphine). | | 8 – Physical activity severely limited | - You can read and converse with effort.<br>- Nausea and dizziness set in as factors of pain.<br>- Strongest painkillers reduce pain for 3–4 hours. | | 9 – Unable to speak | - Crying out or moaning uncontrollably. Near delirium.<br>- Strongest painkillers are only partially effective. | | 10 – Unconscious | - Pain makes you pass out.<br>- Strongest painkillers are only partially effective. |