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A pain scale measures a
patient
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...
's
pain
Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
intensity or other features. Pain scales are a common communication tool in medical contexts, and are used in a variety of medical settings. Pain scales are a necessity to assist with better assessment of pain and patient screening. Pain measurements help determine the severity, type, and duration of the pain, and are used to make an accurate diagnosis, determine a treatment plan, and evaluate the effectiveness of treatment. Accurately measuring pain is a necessity in medical settings, especially if the pain measurement is going to be used as a screening tool, either for potential diseases or medical problems, or as a type of triage to determine urgency of one patient over another. Pain scales are based on trust, cartoons (behavioral), or imaginary data, and are available for neonates, infants, children, adolescents, adults, seniors, and persons whose communication is impaired. Pain assessments are often regarded as "the 5th
Vital Sign
Vital signs (also known as vitals) are a group of the four to six most crucial medical signs that indicate the status of the body's vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a p ...
".
It is important to understand what features of pain scales are most useful, least useful, and which aid in understanding. In fact, a patient's self-reported pain is so critical in the pain assessment method that it has been described as the "most valid measure" of pain.
The focus on patient report of pain is an essential aspect of any pain scale, but there are additional features that should be included in a pain scale. In addition to focusing on the patient's perspective, a pain scale should also be free of bias, accurate and reliable, able to differentiate between pain and other undesired emotions, absolute not relative, and able to act as a predictor or screening tool.
Partial list of pain measurement scales
* Alder Hey Triage Pain Score
* Behavioral Pain Scale (BPS)
*
Brief Pain Inventory
The Brief Pain Inventory is a medical questionnaire used to measure pain
Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and ...
(BPI)
* Checklist of Nonverbal Pain Indicators (CNPI)
*
Clinical Global Impression
The Clinical Global Impression (CGI) rating scales are measures of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders. It is a brief 3-item observer-rated scale that can be us ...
(CGI)
* COMFORT scale
* Color Scale for Pain
* Critical-Care Pain Observation Tool (CPOT)
* Dallas Pain Questionnaire
* Descriptor differential scale (DDS)
*
Dolorimeter
A dolorimeter is an instrument used to measure pain threshold and pain tolerance. Dolorimetry has been defined as "the measurement of pain sensitivity or pain intensity". Dolorimeters apply steady pressure, heat, or electrical stimulation to some ...
Pain Index (DPI)
* Edmonton Symptom Assessment System
*
Face Legs Activity Cry Consolability scale
* Faces Pain Scale – Revised (FPS-R)
[Instructions in many languages and images](_blank)
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* Global Pain Scale
* Lequesne algofunctional index: a composite measure of pain and disability, with separate self-report questionnaires for hip and knee OA (osteoarthritis):
** Original index (1987)
** 1991 revision
** 1997 revision
* Mankoski Pain Scale
* McGill Pain Questionnaire
The McGill Pain Questionnaire, also known as McGill Pain Index, is a scale of rating pain developed at McGill University by Melzack and Torgerson in 1971. It is a self-report questionnaire that allows individuals to give their doctor a good descr ...
(MPQ)
* Multiple Pain Rating Scales
* Neck Pain and Disability Scale –NPAD
* Numerical 11 point box (BS-11)
* Numeric Rating Scale (NRS-11)
* Oswestry Disability Index
* Palliative Care Outcome Scale (PCOS)
* Roland-Morris Back Pain Questionnaire
* Support Team Assessment Schedule (STAS)
* Wharton Impairment and Pain Scale (WIPS)
* Wong-Baker FACES Pain Rating Scale
* Visual analog scale
The visual analogue scale (VAS) is a psychometrics, psychometric response scale that can be used in questionnaires. It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. When responding to a VA ...
(VAS)
Specialized tests
* Abbey pain scale for people with end-stage dementia
* AUSCAN: Disease-Specific, to assess hand osteoarthritis outcomes.
* Colorado Behavioral Numerical Pain Scale (for sedated patients)
* CPOT For those who can't self report
* Osteoarthritis Research Society International-Outcome Measures in Rheumatoid Arthritis Clinical Trials (OARSI-OMERACT) Initiative, New OA Pain Measure: Disease-Specific, Osteoarthritis Pain
* Oucher Scale for Pediatrics
* Pain Assessment in Advanced Dementia (PAINAD)
Pain Assessment in Advanced Dementia (PAINAD) is a pain scale developed by Victoria Warden, Ann C. Hurley, and Ladislav Volicer to provide a universal method of analysing the pain
Pain is a distressing feeling often caused by intense or damag ...
* Pediatric Pain Questionnaire (PPQ) for measuring pain in children
* Premature Infant Pain Profile (PIPP) for measuring pain in premature infants
Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 2 ...
* Schmidt Sting Pain Index
The Schmidt sting pain index is a pain scale rating the relative pain caused by different hymenopteran stings. It is mainly the work of Justin O. Schmidt (born 1947), an entomologist at the Carl Hayden Bee Research Center in Arizona, United States ...
and Starr sting pain scale
The Starr sting pain scale was created by the entomologist Christopher Starr as a scale to compare the overall pain of hymenopteran stings on a four-point scale, an expansion of the "pain index" originally created by Justin Schmidt. 1 is the lowe ...
both for insect stings
* WOMAC : Disease-Specific, to assess knee osteoarthritis outcomes.
Numeric rating scale
The Numeric Rating Scale (NRS-11) is an 11-point scale for patient self-reporting of pain. It is based solely on the ability to perform activities of daily living
Activity may refer to:
* Action (philosophy), in general
* Human activity: human behavior, in sociology behavior may refer to all basic human actions, economics may study human economic activities and along with cybernetics and psychology may st ...
(ADLs) and can be used for adults and children 10 years old or older.
Pain interferes with a person's ability to perform ADLs. Pain also interferes with a person's ability to concentrate, and to think. A sufficiently strong pain can be disabling on a person's concentration and coherent thought, even though it is not strong enough to prevent that person's performance of ADLs. However, there is no system available for measuring concentration and thought.
In endometriosis
The most common pain scale for quantification of endometriosis
Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Most often this is on the ovaries, f ...
-related pain is the visual analogue scale
The visual analogue scale (VAS) is a psychometric response scale that can be used in questionnaires. It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. When responding to a VAS item, respond ...
(VAS). A review came to the conclusion that VAS and numerical rating scale (NRS) were the best adapted pain scales for pain measurement in endometriosis. For research purposes, and for more detailed pain measurement in clinical practice, the review suggested use of VAS or NRS for each type of typical pain related to endometriosis (dysmenorrhea
Dysmenorrhea, also known as period pain, painful periods or menstrual cramps, is pain during menstruation. Its usual onset occurs around the time that menstruation begins. Symptoms typically last less than three days. The pain is usually in the ...
, deep dyspareunia
Dyspareunia ( ) is painful sexual intercourse due to medical or psychological causes. The term ''dyspareunia'' covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the f ...
and non-menstrual chronic pelvic pain
Pelvic pain is pain in the area of the pelvis. Acute pain is more common than chronic pain. If the pain lasts for more than six months, it is deemed to be chronic pelvic pain. It can affect both the male and female pelvis.
Common causes in include ...
), combined with the clinical global impression
The Clinical Global Impression (CGI) rating scales are measures of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders. It is a brief 3-item observer-rated scale that can be us ...
(CGI) and a quality of life
Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...
scale.
See also
* SOCRATES (pain assessment)
* Pain management in children
Pain management in children is the assessment and treatment of pain in infants and children.
Types Acute
Usually, acute pain has an obvious cause and is expected to last for a few days or weeks. It is usually managed with medication and non-phar ...
Notes
{{General symptoms and signs
Pain