Pain is one of the first things you assess and one of the most common things you reassess, so it is worth getting right in Spanish. The good news is that the 0 to 10 numeric scale works almost exactly the same way in Spanish as in English. The harder part is everything around the number: where it hurts, what it feels like, and whether it is getting better. This guide covers the scale itself, the follow-up questions, the words patients use to describe pain, and a few cultural points that change how people answer.
The 0 to 10 pain scale in Spanish
The core question is short:
- "Del 0 al 10, ¿qué tan fuerte es su dolor?" (dehl SEH-roh ahl dyehs, keh tahn FWEHR-teh ehs soo doh-LOR): "From 0 to 10, how strong is your pain?"
- Then anchor both ends: "0 es sin dolor. 10 es el peor dolor que se pueda imaginar." (SEH-roh ehs seen doh-LOR. dyehs ehs ehl peh-OR doh-LOR keh seh PWEH-dah ee-mah-hee-NAR): "0 is no pain. 10 is the worst pain you can imagine."
Many patients will answer with a word instead of a number. These are the common ones, and roughly where they tend to fall:
| Number | Spanish | English |
|---|---|---|
| 0 | Sin dolor / No me duele | No pain |
| 1 to 3 | Un poco / Leve | A little / Mild |
| 4 to 6 | Moderado / Regular | Moderate |
| 7 to 9 | Fuerte / Mucho dolor | Severe / A lot of pain |
| 10 | El peor dolor / Insoportable | Worst pain / Unbearable |
If you get a word, show the scale and ask again for the number so your reassessment is comparable: "¿Qué número le daría?" (keh NOO-meh-roh leh dah-REE-ah), "What number would you give it?"
Note that "regular" means "so-so" or "average" in Spanish, not "normal". A patient who says their pain is "regular" is telling you it is moderate.
Show the scale, don't just say it
Numbers spoken quickly in a second language are easy to mishear, especially six (seis) and seven (siete), or twelve and two if a patient goes off-scale. Pointing at a printed scale removes that risk and also works for patients with limited literacy. For children and some older adults, a faces-style scale is often easier than numbers; use the version your facility has approved.
Follow-up questions (a Spanish OPQRST)
Once you have a number, these questions cover the usual pain assessment. Ask them as yes/no or short-answer questions when you are working without an interpreter.
| Purpose | Spanish | English |
|---|---|---|
| Location | ¿Dónde le duele? Muéstreme con un dedo. | Where does it hurt? Show me with one finger. |
| Onset | ¿Cuándo empezó el dolor? | When did the pain start? |
| Onset | ¿Empezó de repente o poco a poco? | Did it start suddenly or little by little? |
| Provocation | ¿Qué lo empeora? ¿Qué lo mejora? | What makes it worse? What makes it better? |
| Quality | ¿Cómo es el dolor? | What is the pain like? |
| Radiation | ¿El dolor se extiende a otra parte? | Does the pain spread anywhere else? |
| Time | ¿Es constante o va y viene? | Is it constant or does it come and go? |
| Treatment | ¿Tomó algo para el dolor? ¿Qué y a qué hora? | Did you take anything for the pain? What and when? |
| Reassessment | ¿Cómo está el dolor ahora, del 0 al 10? | How is the pain now, from 0 to 10? |
Words patients use to describe pain
"¿Cómo es el dolor?" is an open question, so it helps to recognize the answers. You can also offer choices: "¿Es punzante, quemante o como presión?"
| Spanish | English |
|---|---|
| Punzante / Como una puñalada | Stabbing / Sharp |
| Quemante / Ardor / Me arde | Burning |
| Sordo | Dull |
| Como presión / Como un peso | Pressure / Heaviness |
| Opresivo / Me aprieta | Squeezing / Tight |
| Cólico / Retortijones | Cramping |
| Pulsátil / Me late | Throbbing |
| Como un toque / Como corriente | Shooting / Electric |
| Hormigueo | Tingling / Pins and needles |
| Adolorido / Me duele todo | Sore / Aching all over |
A few phrasing points: patients usually say "me duele la cabeza" (my head hurts) rather than "tengo dolor de cabeza", and "me duele aquí" while pointing. "Me arde" for burning is extremely common for urinary symptoms and heartburn ("agruras" in Mexico, "acidez" more widely).
Cultural points that change the answer
- Understatement is common. Some patients, particularly older adults, may minimize pain out of respect for staff or a belief that enduring pain is expected. "Un poquito" can mean more than a little. Watch nonverbal cues and reassess.
- "Aguantar" (to tough it out) is a value for many people. Saying "Está bien decirme si le duele" (It's okay to tell me if it hurts) gives permission.
- Family may answer for the patient. Gently redirect the question to the patient: "Quisiera que me conteste el paciente, por favor." (I'd like the patient to answer, please.)
- Some patients may worry about pain medicines, for example about addiction or side effects. That conversation deserves a qualified interpreter, not a phrase card.
When to bring in an interpreter
A pain score and a few yes/no questions are reasonable to handle with basic Spanish. A new or changing pain complaint, chest or abdominal pain workups, pain plans that involve opioids, and anything involving consent or discharge teaching need a qualified medical interpreter. Patients have a right to one at no cost in most U.S. health settings, and it protects you as much as them.
Put the scale on your badge
A badge card (often called a "badge buddy") keeps the scale where you need it: you flip it, the patient points, and you document a number. Our free 3-card medical Spanish badge sample includes the 0 to 10 pain scale, pain questions and a BE-FAST stroke check, written by a certified medical interpreter. The full Medical Spanish Badge Cards set ($7) has 18 cards covering pain, triage, stroke check, pediatrics, OB and discharge, with Spanish in bold and English underneath. If you are building your Spanish more broadly, the Medical Spanish Kit ($19) adds the pocket guide and 399 flashcards.
For more everyday phrases, see 50 medical Spanish phrases every nurse should know. Going further: the step-by-step pain assessment in Spanish for nurses covers OLDCARTS and reassessment, and the medical Spanish collection has every bedside resource in one place.
Medical Spanish Desk
General education, not medical advice. Ask your own clinician about your situation. In an emergency, call 911.