Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 1;163(12):e1184-e1191.
doi: 10.1097/j.pain.0000000000002692. Epub 2022 May 18.

Reliability and responsivity of pain intensity scales in individuals with chronic pain

Pramote Euasobhon  1 , Raviwon Atisook  1 , Kulsiri Bumrungchatudom  1 , Nantthasorn Zinboonyahgoon  1 , Nattha Saisavoey  2 , Mark P Jensen  3
Affiliations

Reliability and responsivity of pain intensity scales in individuals with chronic pain

Pramote Euasobhon et al. Pain. .

Abstract

Prior research supports the validity and short-term test-retest stability of 4 commonly used scales for assessing pain intensity (Visual Analogue Scale [VAS], 6-point Verbal Rating Scale [VRS-6], Numerical Rating Scale [NRS-11], and Face Pain Scale-Revised [FPS-R]). However, the relative stability and ability of these measures to detect changes in pain intensity over longer time periods have not yet been examined, although knowledge regarding these psychometric issues is important for selecting from among these measures. To address this knowledge gap, we administered these scales assessing worst and average pain intensity to 250 chronic pain outpatients on 2 occasions, a little over 6 weeks apart on average. All 4 scales were found to be valid for detecting decreases in pain, and the VAS, NRS-11, and FPS-R evidenced the most validity for detecting increases in pain. The NRS-11 and VAS evidenced better test-retest stability than the VRS-6 and FPS-R. Age affected the ability of the VRS-6 for detecting improvement in worst pain, as well as the ability of the VAS for detecting worsening in both worst and average pain. However, the psychometric properties of the scales were not influenced by education level. Overall, the NRS-11 emerged as showing the most sensitivity and stability. The FPS-R seems to be a good second choice to consider for samples of individuals who might have difficulty understanding or using the NRS-11.

PubMed Disclaimer

Comment in

References

    1. Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res 2018;11:851–6.
    1. Atisook R, Euasobhon P, Saengsanon A, Jensen MP. Validity and utility of four pain intensity measures for use in international research. J Pain Res 2021;14:1129–39.
    1. Bellamy N, Campbell J, Syrotuik J. Comparative study of self-rating pain scales in rheumatoid arthritis patients. Curr Med Res Opin 1999;15:121–7.
    1. Bergh I, Sjostrom B, Oden A, Steen B. An application of pain rating scales in geriatric patients. Aging (Milano) 2000;12:380–7.
    1. Bolognese JA, Schnitzer TJ, Ehrich EW. Response relationship of VAS and Likert scales in osteoarthritis efficacy measurement. Osteoarthritis Cartilage 2003;11:499–507.

Publication types