And the pain scale is useful when you are talking to someone who is not used to talking about their internal feelings -- some people aren't as expressive as others. And some people have less of a grasp on the language you are communicating in. I would expect if I were a doctor or nurse, I wouldn't want to base my standard of care on how capable my patient is of finding an appropriate adjective to describe how they feel.
But then, what is a 10? If you have no other instruction, mapping 10 to an extreme seems reasonable. Every time someone asks me this question I think of the time I broke a bone and the pain is never anywhere close to that and I know there must be something even more painful... so what am I to do?
But even that was not a 10! When I was taken off of anesthesia before painkillers were adminstered, following a multilevel lumbar interbody fusion that lasted 7 hours, I achieved an entirely new level yet again that I thankfully only vaguely rememeber because of the general haziness of memory formation post-surgery. I know I screamed at the top of my lungs begging a nurse to kill me, and I had no other working senses except pain, but I don't really remember what it was like qualitatively.
Conversely, I broke my hand about a month ago, fourth metacarpal into four pieces with a 7mm displacement, and I didn't even seek treatment for a week and a half because I thought it couldn't be broken because I had never before broken a bone and expected it to be obvious from pain, but the sensation didn't even register to me as pain.
All of which is a long-winded way of saying yes, there are levels of pain you cannot even conceive of if you never experience it and it does make me question the usefulness of the scales, in that when I first enrolled in pain management before things got truly bad, I was typically rating a 6 what today I'm not sure I would even rate a 1, but as far as I know, providers are aware of this and only use your numerical rating to assess how much your level of pain changes over short enough spans of time that your Pain Overton Window hasn't totally shifted in the meantime.
