Pain scale

Pain scales are tools that can help health care providers diagnose or measure a patients pain‘s intensity. The most widely used scales are visual, verbal, numerical or some combination of all three forms.

Many pain scales include a use of cartoon faces with different expressions. These are often useful when used with children.

In 1999, the Veteran’s Administration adopted the slogan “Pain is the fifth vital sign“, and encouraged greater use of pain scales in initial diagnoses.

One of the most common pain scale is the Wong-Baker Faces Pain Rating Scale. The Wong-Baker scale goes from 0 to 5:

Not all scales are measured on a single axis. For example, the “Brief Pain Inventory” is performed in interview form to identify how pain affects different aspects of the patient’s life.

• Visual analog scale (VAS)^[1] An observational study concluded “the minimum clinically significant change in patient pain severity measured with a 100-mm visual analog scale was 13 mm.”^[2]
• McGill Pain Questionnaire (MPQ)^[3]
• DDS^[4]
• Faces Pain Scale (FPS)^[5][6]
• Pediatric Pain Questionnaire (PPQ)
• Faces Pain Scale – Revised (FPS-R) (Hicks, C., scale is from 1-10)
• Faces, Legs, Activity, Cry, Consolability (FLACC)
• Premature Infant Pain Profile (PIPP)
• Numerical 11 point box (BS-11)^[7] Pain may be quantified on a pain numeric rating scale (NRS) that ranges from 0-10 points (0 means no pain); however, the accuracy of such as scale (using a cut point of 4 or more) for predicting pain that interferes with functioning is:^[8]
  • sensitivity 64%
  • specificity 83%
• 10 and 21 point scales^[9]
• Schmidt Sting Pain Index
• Starr sting pain scale
• Verbal Rating Scale (VRS)
• Simple Descriptive Pain Scale (SDS)
• Wong-Baker Pain Faces Rating Scale (PFS)^[10]
• Numerical Pain Scale (NPS)
• Numeric Rating Scale (NRS-11)^[11]
• Eland Scale
• Modified Eland Scale
• Cube Test
• Faces Scale
• Modified Faces Scale
• Brief Pain Inventory (BPI)
• Mankowski Pain Scale (SKIP), from 0 to 10
• Dolorimeter Pain Index (DPI)
• The Walid-Robinson Index (WRI) = Pain intensity upon admission (from 0 to 10) X Length of pain suffering (in months)

• McGill pain index
• Schmidt Sting Pain Index
• Dol
• Pain and nociception

• Wong scale
• Mankoski scale
• Example of scale
• Herr K, Mobily P, Kohout F, Wagenaar D (1998). “Evaluation of the Faces Pain Scale for use with the elderly”. Clin J Pain. 14 (1): 29–38. PMID 9535311.CS1 maint: Multiple names: authors list (link)
• VA — ‘pain as the fifth vital sign’
• Cleeland C, Ryan K (1994). “Pain assessment: global use of the Brief Pain Inventory”. Ann Acad Med Singapore. 23 (2): 129–38. PMID 8080219.
• A COMPARATIVE STUDY OF PAIN MEASUREMENT SCALES IN ACUTE BURN PATIENTS, Shailaja S. Jaywant, Anuradha V. Pai, The Indian Journal of Occupational Therapy : Vol. XXXV : No. 3, Dec. – March 2003-04.

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