Pain scale

A pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational (behavioral), or physiological data. Self-report is considered primary and should be obtained if possible. Pain scales 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."

Examples of pain scales

	Self-report	Observational	Physiological
Infant	—	Premature Infant Pain Profile; Neonatal/Infant Pain Scale	—
Child	Faces Pain Scale - Revised; Wong-Baker FACES Pain Rating Scale; Coloured Analogue Scale	FLACC (Face Legs Arms Cry Consolability Scale); CHEOPS (Children's Hospital of Eastern Ontario Pain Scale)	Comfort
Adult	Visual Analog Scale (VAS); Verbal Numerical Rating Scale (VNRS); Verbal Descriptor Scale (VDS); Brief Pain Inventory	—	—

Partial list of pain measurement scales

This list is incomplete; you can help by expanding it.

• Alder Hey Triage Pain Score
• Behavioral Pain Scale (BPS)
• Brief Pain Inventory (BPI)
• Checklist of Nonverbal Pain Indicators (CNPI)
• Clinical Global Impression (CGI)
• Critical-Care Pain Observation Tool (CPOT)
• COMFORT scale
• Dallas Pain Questionnaire
• Descriptor differential scale (DDS)
• Dolorimeter Pain Index (DPI)
• Edmonton Symptom Assessment System
• Faces Pain Scale - Revised (FPS-R)
• Face Legs Activity Cry Consolability 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
• McGill Pain Questionnaire (MPQ)
• Neck Pain and Disability Scale –NPAD
• Numerical 11 point box (BS-11)
• Numeric Rating Scale (NRS-11)
• OSWESTRY Index
• Palliative Care Outcome Scale (PCOS)
• Roland-Morris Back Pain Questionnaire
• Support Team Assessment Schedule (STAS)
• Wong-Baker FACES Pain Rating Scale
• Visual analog scale (VAS)

Specialized tests

• Disease-Specific Pain Scale: DSPI = (ΣX · Y) · 100 where X is the highest pain level on a 0–10 scale and Y is the percentage of this pain level in the group. The DSPI is different from the simple numeric 0–10 scale in that it is measured for a group of patients with a specific diagnosis whereas the numeric 0–10 pain scale is administered individually.
• Pediatric Pain Questionnaire (PPQ) for measuring pain in children
• Premature Infant Pain Profile (PIPP) for measuring pain in premature infants
• Schmidt Sting Pain Index and Starr sting pain scale both for insect stings
• Colorado Behavioral Numerical Pain Scale (for sedated patients)
• AUSCAN: Disease-Specific, to assess hand osteoarthritis outcomes.
• WOMAC : Disease-Specific, to assess knee osteoarthritis outcomes.
• Osteoarthritis Research Society International-Outcome Measures in Rheumatoid Arthritis Clinical Trials (OARSI-OMERACT) Initiative, New OA Pain Measure: Disease-Specific, Osteoarthritis Pain

Numeric Rating Scale

The Numeric Rating Scale (NRS-11) is an 11–point scale for patient self-reporting of pain. It is for adults and children 10 years old or older.

Rating	Pain Level
0	No Pain
1–3	Mild Pain (nagging, annoying, interfering little with ADLs)
4–6	Moderate Pain (interferes significantly with ADLs)
7–10	Severe Pain (disabling; unable to perform ADLs)

In endometriosis

The most common pain scale for quantification of endometriosis-related pain is the visual analogue scale (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, deep dyspareunia and non-menstrual chronic pelvic pain), combined with the clinical global impression (CGI) and a quality of life scale.

See also

• SOCRATES (pain assessment)