How to Open a Bank Account in Hong Kong

 I wrote some how-to articles a few years ago on how to open bank accounts in various places for people who are residing temporarily or moving to a new country. I have a few I will start to post and this one was detailed and and I thought this one might be of interest. 

 Opening a Bank Account in Hong Kong

Hong Kong is one of the largest cities in the world. It is also a huge financial center with a lot of opportunities to become successful. This is why so many people continue to move here on a regular basis. If you are planning to come here to live, you will need to get your finances situated. You will need to open a bank account in Hong Kong. Don't worry, the process is not that hard and you don't have to be a native born citizen. Even someone visiting the country temporarily is allowed to open an account if you know someone who lives in Hong Kong. 

Types of Bank Accounts

There are a variety of different kinds of bank accounts you can open in Hong Kong. Depending on what you need from one, you have a few choices in how to handle your finances. We all have a variety of what we need from a bank so here are A few of the most common types of accounts :

  • Checking accounts allow you to do pre-authorized purchases on a reoccurring basis and to do your bill paying, shopping online and in store and daily basic shopping you need to survive activities. You can withdraw from an atm as well. 
  • Savings account- These are generally to hold money in to earn interest on your money that is in excess of what you use daily. You can withdrawal money from an atm as well. 
  • Timed deposit accounts for money you can wait to withdrawal 
  • Investment accounts which also have time limits

Situations Where Your Home Country and Hong Kong Have the Same Bank

If you use an institution that has both branches in Hong Kong as well as your home country, you may be in luck. You may be able to transfer your bank account to the Hong Kong branch. You will need all of the standard required documents that a bank requires like identification of course. You may need as well, photocopies of admissions to a university letter or an employment letter stating your intent to move to Hong Kong. In some instances, keeping a bank account in your home country may be necessary to prove you have enough money to apply for an account out of the country. Once you have moved, pick up your new ATM card from the branch in Hong Kong you plan on using as your primary bank. 

Minimum Account Requirements 

No matter where or how you set up your Hong Kong bank account , your ATM access code needs to be set upon showing up in person. This is for your security. You also need to have the minimum deposit amount in your account. It is usually HKD $1000 in most places. Of course it can vary from bank to bank. It is required to be in your account within three days of setting it up. 

Timed Deposit Account

You can apply for timed deposit multi currency accounts. You tell the Bank how long you will purchase the foreign money for and sign an agreement to the terms. Be sure to read everything that you sign carefully. It is always vital to read all terms and conditions when dealing with financial institutions.

More About ATM's

Although you need to set the pin in person, your new ATM card will be ready for either pick up or delivery within 3-7 days. There will be directions enclosed in the envelope the card comes in. This will teach you how to activate and use it. Some things are different about ATM cards in Hong Kong compared to other countries. You can't use your card at all ATM counters and you need to set up which services you can access.

 Examples of this are-

Account members of HSBC and Hang Seng Bank can only take out and deposit money and pay their bills in each other's ATMs. 

All other banks can use their own ATMs as well as ATMs that have a JETCO sign. 

Debit cards that have EPS on them can purchase in stores that accept EPS. If the card says VISA, it works as a standard VISA debit card.

Can a Bank Account in Hong Kong be Opened by a Non-Citizen? 

Because Hong Kong is such an international hub for many business activities many of the people of Hong Kong come and go. It is considered is a transient city for many people who reside here. Banks realize this and make opening a standard bank account in Hong Kong fairly simple. If you are a member of the European Union or are American or Australian and have a passport, opening an account is quick. For all other countries, the application process can take 2 weeks.

Can I Open A Bank Account Online?

If it is your first bank account in Hong Kong, you can not open it online in general. However, if you already have one account, you may. There is strict laws regarding money laundering so there are rules in place to prevent it. Once you have internet banking set up, you can open as many accounts as you like. An exception would be If your home bank is also in Hong Kong, you can do it online. Your local bank can assist you in the process and send all paperwork to Hong Kong for you. Be advised, do this at least a month in advance of moving. Once you get to Hong Kong, go to your bank to activate your account and it will be fully active within 15-20 days. Business accounts are different and much more strict. Even if you have a personal account in good standing, you must apply in person for this service. Banks in Hong Kong are very secure and want to keep it that way. Be prepared to follow the rules as it is for your own protection and the protection of all of the banking institutions and their customers. You wouldn't want someone else to be able to bypass the rules that you had to follow to get a new bank account in Hong Kong.

Choosing an Area That Deals With International Clientele

There are areas in Hong Kong that have expats who are experienced in dealing with international accounts. Discovery Bay, Central Hong Kong and Mid-Levels are all good areas to choose a branch. The employees are used to handling customers from other countries and will be better at understanding your needs and language. 

The following documents will be required to open an account

  •  Your government identification card or drivers license. A passport or HK ID card can also be used;
  • Proof of where you live like an electric bill, phone bill, or a bank statement from another bank that is less than 90 days old.      
  • If you do not have an address, you can use someone that is related to you or is a friend's house that you can receive mail at and send mail from. 
  • A visa that is current and up to date  
  • If you’re working in Hong Kong, bring a letter stating your employment from your boss.
  • For students, bring an official letter from your college stating that you are registered as a student there.

The HK ID Card

Getting an H K ID card is a really good idea so you can use a variety of services in Hong Kong. Here is a link to more information on obtaining a Hong Kong ID Card Get your Hong Kong Identification Here It is also necessary if you are over 11 years of age and will be staying in Hong Kong over six months. It lets you get more benefits such as;

  • Qualifies you for more Public Services then someone who does not have a HK card
  • It Allows you to get a Library Card as it is required 
  • Clearance from immagration
  • It is even more secure than using a passport
  • Needed for opening a business Bank Account in Hong Kong
  • Greatly assists you having your identity stolen from ID thieves
  • They are free with the Registration of Persons Office. Book an appointment there, take your visa and passport with you. Fill out an application form, bring two pictures of you and you should get your card in 10 days. 
  • For FAQ go directly Here for FAQ on HK ID and Smart Idenity Card

Business Bank Accounts in Hong Kong 

If you are in the beautiful city of Hong Kong for business reasons then you are very lucky to have the chance to work in such a gorgeous city. However be prepared to do more research and spend more time opening a business bank account Hong Kong. The process of opening a business account is more detailed than opening a basic or personal Hong Kong bank account. It used to be easy to open a business account here, however people got accounts in other countries to launder money, so they have had to crack down on who has access to business accounts. 

Know Your Customer 

The KYC or Know Your Customer rules are in place to make sure only legitimate corporations hold accounts. This is a company that explains it a bit. I have no affiliation with them but they explain it in good detail. Learn more about KYC  Detailed information about the business and all partners in the company and employees are required. 

Picking a Bank That is Right For You

There are so many banks in the general Hong Kong area that it can be a tough choice to pick which banking beach to use. In fact, banking in Hong Kong is so popular, that  there are over 250 branches in the vicinity. That can make deciding which one to do business with a tough choice. If you are already using a bank in your home country that is also located in Hong Kong, you are in luck. Continue using their services. The banks in the area sually have the same types of services with some variations. They all love new customers. There is usually incentives to open a new account, or keep your current bank if they have a branch in the area. Find the bank with the best incentives for opening a new foreign bank account if you are not a native of the area and this also applies to residents who were born in Hong Kong. Find the best incentives for the type of banking needs that you have.

Looking at the Largest Banks in Hong Kong

There are a few banks in Hong Kong that stand out due to being the biggest. They all offer different incentives to open an account. You can compare them to see which one may be the best fit for you. 

HSBC Big Bank 

HSBC is the biggest of the international banks. They offer an instant savings account which allows you to choose the currency and offers interest. If you don't need it right away, there is a time deposit account with higher interest rates than a standard account. They offer a loan that is approved instantly and has a flat rate of .13% per month. You can borrow up to 12x what you make in a year.


Standard Chartered 

This bank has incentives like mileage for flights and cash rewards for new clients. They have an integrated deposit account which lets you access all accounts easily. They also offer an ATM card with dual currency.https://www.sc.com/hk


 Citibank hong Kong branches are easy to open. If you already have an account, you get Citigold status at the Hong Kong location. There is free ATM use from their banks world wide. You can transfer money for free between your home and Hong Kong accounts.https://www.citibank.com.hk/

Hang Seng Banking 

 This branch is part of HSBC so they have a lot of the same services and rates. They are a great bank for students. This is because you get no monthly fee on your account and for three years after graduation, a free credit card. There is also overdraft protection and free currency withdrawals from your home country.


Bank of China 

The Bank of China is the best choice if you go to the rest of the country of China often. They are a part of Jetco and Union Pay. This is a big ATM network in China all over. Overseas transactions have a low withdrawal fee and some transactions at grocery stores and department stores are free with the EPS sign. https://en.m.wikipedia.org/wiki/Electronic_Payment_Services

Link here https://www.bochk.com/en/home.html

Fees and Costs 

You always want to read the fine print on any type of bank account that you open.  Depending on the bank you use, you could be paying any number of fees and you do not want an overdraft to be a surprise. These are some of the fees you may find in a Hong Kong bank account. 

  • A minimum balance fee if you are not above the agreed upon amount that is to be in the account. Many banks require that you keep a minimum amount in the bank at all times. Make sure to keep an eye on your bank statements. 
  • Banks need to make money to service customers  A monthly charge called a maintenance fee may be applied. 
  • Checkbooks are still used in Hong Kong on a frequent basis. This isn't common  In some parts of the world. If you get one there may be a delivery charge for the checkbook unless you give an address that is located in Hong Kong. 
  • Early termination fees of up to HKD$200 if you close your account before an agreed apon time limit. Make sure to follow all terms that you agreed to when you sign up with a bank or hefty fees may come your way. Banks help us but they are also a business and personal accountability is necessary to ensure that they can stay open to continue to help hold our money for us.
  • ATM fees can occur if you use a non approved ATM. You can use your own bank ATM for free. Sometimes you can even use others within a network of banks. For example, Jetco but if you use a bank that is not in the approved network it can cost you between HKD 15 and HKD 20 per withdrawal. 
  • International transfer fees can get expensive, costing you between HKD1 15 and HKD1 20 per transfer between accounts. Banks like Citibank offer free international transfers if you have an account in the same banking network. You also have to be careful of exchange rates that are unfavorable. 

I Hope This was Helpful

I wrote this a couple years ago and I just updated it for now and included new links and redid it. I hope that you enjoy it if you read this please comment below. I enjoy hearing from people who read my content and the domain host may even have helpful links you can visit as they are tailored to the articles which is really great. 


Bully Sticks Are Great for Dog Dental Care

Dental Care for Dogs is important. Recently, I got a comment from someone showing me a great product. They didn’t ask me to do this. I appreciate that someone took the time to leave me comments. They read my articles. I checked out their product on my own. After researching the topic, I found out Bully sticks are great for dogs. They can be great for dogs of all ages and sizes.https://dogtreatsus.blogspot.com/2019/12/natural-bully-sticks-for-dogs.html?m=1 Is a source I found for bully sticks and great pet articles as well. I wanted to give them a shout out for helping to make dogs lives better with healthy bully sticks. 

Great Pet Treat Articles

https://dogtreatsus.blogspot.com/2020/01/dog-treats.html?m=1 I like this article about pet treats and the other one I posted. Check them out for healthy bully sticks for pets. I liked the fact that they are good for all breeds and sizes of dogs. Of course, always ask a veterinarian first about any new food or pet treatyou give your dog. Veterinary advice is always good before a new treat is introduced. You can get them at https://dogtreats.us/what-are-bully-sticks/

Tarter Care Bully Sticks and Water Additives for Healthy Dog Teeth

Bully sticks significantly have been found to reduce tartar and plaque buildup on dogs teeth. Dogs need teeth care. They require it just like humans do. Chewing on bully sticks is a great method of tartar reduction. They are one of the many ways to keep your pets teeth healthy. Some dogs require extensive dental care because of owner neglect. Anesthesia and surgery are needed in some extreme cases because their owners have not taken care of their teeth. Some dogs when having their teeth professionally cleaned feel a lot of pain and anxiety. Preventing this involves brushing your dog's teeth, giving them treats that are formulated to remove tarter and water additives like this https://www.chewy.com/arm-hammer-dental-flavorless-odorless/dp/112018?utm_id=272259755&msclkid=29c8fa5a988b1de7a5d89a3bce739f7e&utm_source=bing&utm_medium=cpc&utm_campaign=Shopping-Product%20Targets-Hard%20Goods-NB&utm_term=4584963490329613&utm_content=Dog%20Dental%20Care 

I found this as the lowest price water additives for pets. I have no association with them. I just researched dog dental products.

A Note on Bully Sticks 

 I saw a frequent visitor to my blog who leaves comments for me to read. I appreciate this. I always wrote if someone leaves a comment about something then I will write about it. I am following through on that and thanking them for taking the time to leave comments on my page. Above is a separate link for a cheaper water additive I found as an additional way to help your dog have healthier teeth. I made sure to read their articles on pet teeth care before posting their information links. I will only put up blogs that are original and good. I liked Dogtreatsus  because they post about the benefits of using various methods for dental care for dogs. They make terrific treats in decreasing tartar and plaque and at the same time make great amusement and chewing tools to serve a dual purpose. 

Dental Troubles in Dogs 

Utilizing teeth brushing, bully sticks and water additives will get you the best results. Look around for the easiest tooth brushes to use when choosing to utilize a dog toothbrush as part of a complete canine dental care routine. I learned about all of this on dogtreats.us and got my dog Max some. I appreciate comments that much that I even bought the product.

Curly Bully Sticks for Small Dogs 

The bigger bully sticks are great for medium to large dogs. Smaller dog dental care requires different bully sticks for strong teeth. Small dog breeds need dog treats made for small dogs however. The twisty bully sticks also help more with cleaning the enamel of the teeth properly. It gets into all the hard to teach places that a dog toothbrush can not reach. Dogs love the flavor of them as they come in meat flavored varieties that are perfect For your pets picky palate. We all know how our pets can be when it comes to what they find tasty to chew on.

All dog sizes can benefit from the enhanced chewing these sticks provide. Just be sure to get the right size for your dog and more information on this topic can be obtained at https://dogtreatsus.blogspot.com/2019/12/natural-bully-sticks-for-dogs.html?m=1. Thank you for bringing this topic to my attention and I’m directing all in-depth information back to the source as dogstreatsus is a great source of info all all varieties of bully sticks. 


Question on Quora About Guppy Care and Sick Fish

 Question on Quora- Why does my fish dying? I started a new fish tank, after a while, they started to slow down, isolate themselves and they clamp their fins and eventually they die, I have put a picture for one of the guppies that is starting to act the same.

My answer 

I am not a fish expert but I did go through a phase where I raise guppies. There are many reasons why this can happen. Remember I'm not an expert just somebody that went through a phase of raising guppies went through a phase of raising guppies.

Look at this guppy site

Lot of info here pic from here 


I went further and got you common fish diseases for guppies


Also marine diseases 

Fish Fins Clamping Is Bad

I remember clamping fish fins is an indicator of a possible specific disease. Or a sign of one remember I'm not an expert just a person that had fish tanks and is trying to help you. You need a hospital tank when you notice a fish is sick. Check the ph of the water. If you have the wrong ph that can greatly affect their health.

Here's info on clamped fins.

Clamped Fins - Cause and Treatment - Info from link

"Homeaquarium site with fish and invertebrate profiles, how to’s, DIY, breeding, care, feeding, equipment and maintenance of freshwater and marine aquariums."


There may be bullying going on, not enough room in the tanks, the water needs to be warm enough and treated and you may have aggressive and community fish in there together and they are being harmed. Any stress on a fish can harm them. When doing water changes, around 15–20 percent is changed with a gravel vacuum once a week and put new “at water temperature of the tank in that is treated"

A great fish resource

Clamped Fin Fish Disease from https://www.tropicalfishsite.com/clamped-fin-fish-disease

"Not indicative of one specific disease. Can be a reflection of various problems, including bad water quality and/or parasites. Symptoms: Fins are folded against the body and not fanned out as they should be Listless behaviour Treatment: First test the aquarium water to review overall water quality with a good quality test kit and conduct a partial water change to ensure healthy conditions. A good all round fungus treatment such as protozin should make a difference to most causes of clamped fin fish disease so treatment with this is a good place to start. Prevention: It is important to first determine the specific problem in order to treat fish properly. Good practice of adding 1 tbs. aquarium salt per gallon will help prevent clamped fins. Tropical Fish Site takes no responsibility for diagnosing the exact problem with your tropical fish, this is purely meant as a guide only. Be sure to look at other common tropical fish diseases to ensure you have made the correct diagnosis as there is often crossover between them. Features: always follow package guidelines water treatment for improving fish water quality helps to cure common ailments found in aquariums Model number: 5568 Features: High quality item. Genuine product High quality item. Genuine product Description coming soon Features: Treats Protozoan and Fungal Infections Aquarium Treatment for Costiasis and Trichodiniasis Features: Contains one (1) API Freshwater master kit 800, including 7 bottles of testing solutions, 1 colour card and 4 glass tubes with cap Helps monitor water quality and prevent invisible water problems that can be harmful to fish and cause fish loss Accurately monitors five most vital water parameters levels in freshwater aquariums: pH, High Range PH, Ammonia, Nitrite and Nitrate Designed for use in freshwater aquariums only Use for weekly monitoring and when water or fish problems appear"

Many More Fish diseases Do your Research

This is images of parasite diseases mentioned above 

More diseases

Bacterial Fish Diseases

Viral Fish Diseases

What Ick looks like 

Here's what causes Ick 

There can be other diseases issues, I'm not a fish vet. Please remember this. I am not an expert. This is advice given as an opinion of a prior fish owner who went through fish issues and learned to resolve. This tells you how many fish can go in a tank one inch fish remember so if it says 6–8 fish per 20 gallons that's 6–8 inches of fish. 


Fish & Aquariums


That is the general site I found the information about how many fish to put in there but go through those pages to find more information. Please don't go and just start treating your fish for any possible disease I know it's hard to find fish Doctors I really do so I know that you have to ask on the internet unless you know a fish expert. I would recommend going to your local pet store with pictures of your fish right down all the symptoms and speak to the local fish expert there.

Experts on Fish

Go to a few different pet stores to speak to them. Talk on forums ask as many questions as possible have pictures evidence take videos whatever you can do. Guppies breed fast as well. That means they need more surface room.

Hiding Spots

Fish need plenty of space to themselves and hiding spots to relax. I do not get affiliate link pay so these are what I looked at and read. I didn't expect to answer fish questions today but I'm happy to oblige.

Aquarium Fish Hiding Places

From Chewy helps you understand why fish look for hiding places and how to give them the best hiding places in their aquariums.


Side Note on Snails and Plants

One more thing be careful of buying plants you might end up with a lot of snails. I had a snail infestation from one eBay plant so try to get artificial plants unless you have a source that can guarantee you will not get snails that you can not release in the wild do not ever do that if you have them. It is illegal you have to find a humane way to take them somewhere and speak to your local conservation department about this if this is an issue that you have as well. I just wanted to add that in as a side note.

Never release Anything into the Wild

We never ever release anything that is domestic into the wild. It causes huge issues in our ecological system. I made the mistake of buying the plant on eBay and I ended up having to get multiple tanks just to take care of the snails until that could be handled. I did not ask for this fish taking job my sister abandoned them and I had to figure out a way to learn all this stuff really fast and I did the best I could and I tried to learn the most I could about the pH of water, using correct lighting, using correct hiding spots, and different fish need different pH levels.

Remember I am not an Expert just Directing to resources and Personal Opinion

Although I hope you found this helpful, I am not an expert on tropical fish but experienced enough to direct you to more experience people and to give you personal opinion not advice. This is a disclaimer as I did the best I could to try to help you but please seek out other resources as well. Go through all the links and look up some links of your own and I did request the assistance of more people for you. I really hope I've helped you with info to look into and places to start.


The Five Components of Emotions

 I’m doing a workbook for Ascension. As I do it I save it here so it’s not complete complete in this article. I’m doing on here. Let me know how I do as I go 

Emotional Triggers 

Introduction to the Five Components of Emotions 

Emotions are a roller coaster. When you are dealing with chronic pain as well as emotional pain. We can experience intense emotions, Understanding emotions is a vital component of learning mindfulness to manage chronic pain. You wouldn’t believe how much chronic pain management and emotion disregulation go hand in hand.

Negative Emotions can Trigger Many Feelings 

We will study many kinds of ways that being mindful of your thoughts, feelings, triggers and surroundings can affect you both mentally and physically. Being mindful is a concept we will get into further in this group. Understanding emotions and how they are triggered needs to be understood however first. When we understand that it is ok to feel how we feel and why we do feel certain emotions, everything including managing chronic and acute pain is another effective form of pain management. We will learn how to radically accept (another concept you will learn in this group) our emotions, the hold they have over us and our actions decreases. 

Included note of top examples for most people -

  • You feel anxious when someone leaves you.

  • You think that a person is not listening to you.

  • You feel helpless over situations where you have no control.

  • You do not feel valued or appreciated.

  • You feel that you are not good enough.

  • You think that you are being judged all the time.

  • You feel belittled and worthless.

  • You feel controlled by someone.

The Five Components of Emotions

When we go through the array of  emotions there are five components. Emotions are complicated and individually to each person yet Some of the components remain the same for everybody. When we experience a trigger which is an event that happens internally and externally. They are generally started by an event that occurs usually some thing that is either a major event or it could be a daily event. This leads to more emotions and events that was triggered by one major life change or event or an event that happened earlier in the week or just today for example. It could be a conversation that triggers an emotional response. It could be going to work, it could be an argument with a significant other, it could be the loss of a job, it could be not finding your car keys or having your battery die. When we have chronic pain emotions we feel are so much stronger and so triggers can happen more easily. Learning how to manage these triggers and events can greatly reduce your physical pain as we have mentioned that physical chronic pain and emotional pain go hand-in-hand.  This chart is components when in the workforce. These are similar but a few different components.

You are driving down the road and decide to stop and get gas. On the way you run into a friend who tells you some news they heard about you . It’s not that bad, it's just something that is enough to irritate you a little bit. You continue on your way to the gas station. When you get to the pump, There is a line and you are starting to get a headache. This makes you tired to think that you might get a migraine which is an internal trigger while the others are external triggers. The internal triggers are the ones that are making you think that you were going to get a migraine and the external triggers are the ones that are keeping you from taking some headache medicine. This can start to fire off an emotional state. These all start to set your emotions off.  Included is emotional intelligence and the five elements of that type of emotional reactions.


Your beliefs and assumptions about what is going on will be Exasperated  as emotions take off. Thoughts that fire with emotions are usually emotion-congruent. That is to say, if you feel stressed because there is a line at the gas station, your thoughts are likely to be worry thoughts, rigid "I'm right" thoughts, and that's normal for all people experiencing anxiety 

When you have chronic pain that could either be a regular headache or a migraine. You start to feel secondary emotions and thoughts that you should calm down because it might just be a headache that is caused by being in line and might be a little dehydrated and you’re not gonna have a full-grown migraine.You start to feel angry because the people in front of you were taking too long to feel gas and you feel like it’s wrong to be angry you don’t know the day they’re having. Then you can start to feel like you have no right to be angry because of this and this creates a mixed emotional experience. It can also create a completely new emotional experience like depression that you can’t stand your life anymore everything is too difficult having doing some thing simple as going to get gas. As mentioned earlier, thoughts can also set off emotion as an internal trigger. Do you think the event was positive, unfair, shameful or unbearable? We will continue with the rest as I go. This is the second part of chronic and emotional pain series.


Favorite bark city doggy daycare pics and personal pics

Herman and me and Small dog daycare Binghamton New York. Herman is a miniature dachshund and one of my favorite dogs all of the dogs on here are. I will keep posting dog pictures in case anyone wants to see them.

Next we have Mina and piper. A husky and a pitbull at dog daycare Johnson city New York. 




Eva pia cooper Luna geo.These are all pictures from being a small dog daycare attendant in Johnson City. I miss volunteering there so much and making these reminds me of how happy I made these dogs and how much I’d like to see them again. Are used to run to the back and would wait in line to get into the small dog daycare. Some of the dogs are from the front and the other girls took care of the bigger dogs like Cooper usually and Sully and Mina. I miss being with the dogs and the girls at the daycare. They taught me a lot and it was a lot of fun. I really advanced when I worked on my own and studied constantly and took classes. Dog training is some thing that is not learned overnight and it takes months andSo nobody got to really see what I learned because of the hours I work I didn’t get a chance to show everybody how much I learned. My dog is doing so great and I just really want to volunteer at a dog daycare Binghamton again as it really helps me to feel like I am helping animals.



Types of Pain and how Physical and Emotional Pain Correlate As the disaster duo

What are the Types of Pain One Can Have and How Do We Accurately Assess the Level  of Pain?

Pain is a concept that is different to all people. Many medical facilities use a rating scale of 1-10 to rate your pain. Does this seem like an accurate assessment to you? When asked this question, how do you answer? Most of us think for a minute and pause. Next, we look at the attending physician with a little bit of confusion as to how they will rate your rating. If you say a 5 does that mean you feel "manageable pain"? If you say 10, are you feeling like you are being dramatic when you are truly feeling completely drained  physically, emotionally and all of your thoughts and focuses are on this pain.  Can you truly rate it a 10? 

The Famous 1-10 Scale of Pain Assessment 

Number scales are extremely difficult to use to assess pain. Many chronic pain patients feel some kind of confusion when it comes to the rating scale. We are so afraid of being” rated back” or not taken seriously because each day we feel chronic pain.

Emotional Pain Scale 

When we have chronic pain, it often comes with emotional pain which has yet another chart. This is also incredibly  complex and can be a result of chronic physical pain or vice versa. Chronic emotional pain can also turn to chronic physical pain and the two occur together in most occurrences. This is why handling a chronic pain patient's emotional state is just as important as monitoring and treating the physical pain of a patient.

The correlating Duo 

Serious anxiety and emotional distress can cause some serious pain. The lingering effects of a depressed state will inevitably lead to physical health problems. Chronic physical health problems lead to an unsteady mind state. We cannot generally have one type of pain without the other. If somebody is bedridden and unable to do the things that they find pleasurable in life than they are more likely than not, suffer much in the same way that a person who is grieving suffers. They will grieve the way they used to live their life and how they have to adjust to their new normals. We will discuss how to effectively handle emotions later on in this course as well as Many effective mental health coping mechanisms actually work to treat physical pain because you are treating the emotional pain that is correlating with it. That is why there are mental health professionals that work at pain management clinics. They play a vital role in treating both kinds of pain. Having a healthy emotional state can greatly decrease your physical pain.

When You Deal With Both Types of Pain, Rating it on a Scale Makes it Even Harder

Because emotional and physical pain go hand in hand when dealing with a chronic pain condition, rating our pain on a scale can be a cumbersome task at best . This can make it even more difficult to describe exactly how we are feeling when no one else can even have a clue as to how we are actually feeling both physically and emotionally. Some types of pain can not yet be accurately assessed by a physician. Even with all the medical advancements we have today, some conditions can only be assessed by how we tell the doctor we feel. 

Reasons we Need Pain Scales for Certain Types of Pain 

 We can understand why a pain chart is there. In an acute pain situation, it's more useful. An example would be, you were climbing a ladder and fell off. This causes an ankle injury. The doctor takes an x-ray and sees that bones are broken. So, when in an acute situation saying that you feel a level of pain of an 8 or 9 because you have a newly fractured bone, the pain scale makes sense. It can be measured by a scan of the bones so the number you say correlates with the scientific evidence in front of the person treating you. A broken ankle can not be ignored. It interferes with tasks. It interferes with your concentration level as well as your basic needs. It also requires bedrest and elevation of the limb to heal so based on this pain scale you would be in a level of pain of a 10.

Acute and chronic Pain Correlate Together as Well

In an emergency setting we may not know the doctor treating us. If something isn't broken but you have acute pain like a migraine, that can be a more complicated assessment. It is not pain that lasts forever, Pain may be both chronic and acute at the same time. Some days you feel less bad and can deal and others you have migraines that come on abruptly. Sometimes they can be managed by over the counter medications, or prescriptions from a general practitioner.  Other days, the migraines are so bad that they are considered a "10" and require emergency treatment. Migraines are both acute and chronic at the same time  

Chronic pain is a condition that lasts for more than three months and various treatments can manage it but there is no exact cure.It causes underlying anxiety, depression, fatigue and a loss of interest in activities that you once enjoyed. You may feel stress that a certain situation or food may possibly trigger an acute migraine bad enough that emergency medical assistance is necessary. This causes you to avoid certain activities and things you enjoy and now you are dealing with emotional symptoms triggered by your chronic pain condition. 

We all feel pain differently

 Not one person feels pain the same way that another person feels it. Human beings are completely unique in this way. When it comes to chronic pain,because we are so used to feeling like we are in a level of pain like a 10, we may assess our pain differently to a doctor and say it is a six. A migraine is not something that can be seen on an X-ray or a chart. The same thing applies with conditions like fibromyalgia and neurological conditions that affect our lives on a deep level but no doctor can find any evidence of the condition. This is when we have to explore the various treatments that come with chronic long lasting pain that some days may be manageable at home while other times it is not. 

Developed Tolerance to Pain 

When we have chronic pain, we begin to develop a tolerance to it physically, but mentally and realistically,  we are on the level ten on both the 1-10 pain and emotional scales. When something can not be clearly identified by research and lab testing, we may feel like our care providers don't understand how truly bad we are feeling. This is when those  with chronic pain who have a high pain tolerance feel like the pain scale backfires. We can be at a normal person’s eight, where they might be crying and writhing, and yet we are still sitting up, or reclining on the hospital bed, and may be able to even crack a joke here or there as a method of dealing with it.  They ask your pain level and you freeze up because you feel like the above image, hopeless, miserable, feel like crying but there's no more tears to give and you don’t know what number is appropriate.

 To you, there  is pain you can deal with and pain you can’t, and your pain is getting to the point you can’t – that’s why you are there. So you throw out a number. You don’t want to sound dramatic so you low-ball it and the doctor isn’t seeing a patient in that much pain, so what happens? You feel like you wasted a trip and are more exhausted because you weren't having a screaming episode in front of the doctor. So what are we supposed to do, lie there moaning and putting on a huge display to get our needs met?

Communicating With Your Providers is a Key Factor in Treating Your Pain 

In order to effectively treat chronic pain, one has to be able to learn to effectively communicate with the ones treating them. Becoming educated on effective communication methods with the people in your life that help you deal with your emotional  and physical pain can provide you with many more options for treating how you feel. Good communication skills can make a world of difference for chronic pain sufferers. You will learn how to communicate with your doctors and other providers in a way that opens up decreased pain on all levels after this course. A good way to start this is to start giving constructive feedback on how your pain management plan is working.  A fantastic start to this is telling your doctor specific things such as what is shown below are helpful. 

  • How is my life going in general?

  • What does my pain limit me from doing that I would like to be doing if I wasn't hurting constantly. 

  •  What does a typical day look like? 

  • What parts of my day have changed because of the pain I am in ?

  • Am I a possible danger to myself because of the pain? 

  • How much time each day am I spending in bed?

  • Can I go to work full-time, part-time or not at all?

  • What do I reasonably hope to gain from the visit? 

  • Do I feel lonely, anxious, hopeless, irritable or a variety of other mental states that I should tell my provider?

Additional Types of Pain

We have discussed acute as well as chronic pain and touched a bit on how they can intertwine and affect each other. There are various types of pain however that can greatly interfere in one's life. 

Neuropathic pain:

Nerve Pain can be one of the most sensitive types of pain there is. It occurs when there is damage to the nerves or other parts of the nervous system. Some common symptoms of this variety of pain are-

  • Often described as shooting, stabbing, pins and needles, or burning pain

  • Can affect sensitivity to touch

  • Common type of chronic pain

  • Can be intermittent as when one feels like they are doing okay one day and the next can also be so  severe that it makes performing everyday tasks difficult. 

  • Can lead to mobility issues

Understanding Nociceptive pain

This is often the type of pain that causes permanent damage to some area of the body or body tissue. 

  • Often described as being a sharp, achy or throbbing pain

  • Often caused by an external injury 

  • Often experienced in the joints, muscles, skin, tendons and bones

  • Can be both acute or chronic

Radicular pain:

Very specific type of pain that can occur when the spinal nerve gets compressed or inflamed

Radiates from the back and hip into the legs by way of the spine or spinal nerve root. This can feel both neurologically painful and chronically painful. 

  • Experience tingling, numbness and muscle weakness

  • Commonly known as sciatica because the sciatic nerve being affected

  • Pain is often steady and people can feel it deep in the leg

  • Walking, sitting and some other activities can make it worse 

Post Surgical Pain

When one has an upcoming surgery, generally there is a great amount of fear about the pain they will have. Surgical pain comes from an incision being made that causes damage to the surrounding tissue. Sometimes the procedure itself, such as a cystoscopy can cause pain. This is an exploratory surgery. There is no technical cutting or incisions but the exploratory nature of the procedure itself, causes post surgical pain. This type of pain is caused by the use of force of an instrument that stretches the area being explored further.  

One can also have pain from a breathing tube that has germ inserted. This can cause the throat to experience irritation. 

If it is a long surgery or the positioning necessary for your body to be in, is uncomfortable, this can cause pain as well. 

Superficial Somatic Pain

When you have Somatic pain, this comes from an injury of some kind. They can be as simple as falling off the bike and scraping your knee or having surgery or a biopsy and the cuts and wound area hurts for a while until it heals. It can also be from surgical pain from the incision and for the pressure from the force of a surgery.

Deep Somatic Pain

When you have pain that is deeper than superficial pain it is known as Deep somatic pain. 

This type of pain comes from a torn ligament, a muscle being torn or a tendon or a broken bone. Sprains can also cause this kind of pain. Surgical pain involves both types of deep somatic pain and somatic pain. The deep somatic pain is when incision cuts through tissue that is deep. Superficial somatic pain is from the scarring or injury and the outer layers of the skin. 

Central neuropathic pain 

When the brain or spinal cord is injured central neuropathic pain can occur. A Traumatic brain injury can cause central neuropathic pain and injury to the spinal cord. 

Visceral Pain

Visceral pain is from internal organs and it usually is from a digestive system situation or appendicitis. These are some examples there are other types of visceral pain as well. It is hard to always find the exact location of the pain because it may feel general in the area to the patient. It can sometimes take a while to diagnose this type of pain. It can also be caused by surgical pain and different types of damage to organs and infections as well as cancer. A type of visceral pain that happens during surgery is anytime a surgeon cuts through the G.I. tract, that would be an example of this kind of pain. 

 Referred Pain

When the brain receives a lot of information at once by an area of nerves that is unable to distinguish where it is coming from, it is known as referred pain. An example could be a human being grabbing his left arm because he is having a heart attack. He feels pain in that arm so he grabs it. The pain signals are confused and are sending pain to different areas. The bundle transmission of this pain is causing it to expand and go to different areas because the information is coming in so fast that it can’t distinguish where the body is supposed to hurt.

Peripheral neuropathic pain

 Peripheral neuropathic pain starts with nerves that are not part of the spinal cord or the brain. They are the nerves that are in the extremities of the body. These include your arms and legs. 

Phantom Limb Pain

When someone undergoes an amputation of a body part, they can experience a strange type of pain that is quite unique. This is known as phantom limb pain. The limb is missing but the patient feels pain where the body part used to be. It can also happen in areas that are not limbs like a possible situation where a woman has to have a mastectomy. She may feel pain where her breasts used to be and this is also known as a type of phantom limb pain. It used to be thought of as something psychological but research is finding that this type of pain is legitimate and causes patients a great deal of distress. They can actually become in severe pain that is acute and chronic in nature. Sometimes it will be really bad other times it will be tolerable. It is a serious type of pain that is still being studied to understand how to effectively treat patients with phantom limb pain. 

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