Assessing the suitability of four pain intensity scale in patients with chronic musculoskeletal pain
Main Article Content
Abstract
The study compared the concordance of four pain intensity scales: Visual Analog Scale (VAS), Numerical Rating Scale (NRS-11), Verbal Six-Point Rating Scale (VRS-6), and Faces Pain Scale-Revised (FPS-R) in patients with chronic musculoskeletal pain. The cross-sectional study was conducted on patients with musculoskeletal pain at three hospitals: University of Medicine and Pharmacy, Ho Chi Minh City, An Binh, and 199, from December 2024 to June 2025. Patients self-assessed pain intensity using four scales (VAS, NRS-11, VRS-6, FPS-R) in random order. The mean pain intensity according to VAS, NRS-11, FPS-R scales was 5.8 ± 2.1; 5.9 ± 1.9; 5.1 ± 2.04, respectively, the VRS-6 scale recorded moderate pain in the majority (50.7%). The scales had a strong positive correlation (r = 0.77 - 0.92; p < 0.001). VRS-6 was the most preferred by patients (58.3%), followed by NRS-11 (28.0%), FPS-R (10.7%) and VAS (3.0%). The selection of a pain intensity assessment scale for patients should be individualized based on: age, education level, cognitive ability, type of pain and experience using the scale of the patient.
Article Details
Keywords
Pain intensity, Musculoskeletal pain, FPS-R, NRS-11, VAS, VRS-6
References
2. Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001; 93(2): 173-183. doi:10.1016/S0304-3959(01)00314-1.
3. Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: Which to use?. Am J Emerg Med. 2018; 36(4): 707-714. doi:10.1016/j.ajem.2018.01.008.
4. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011; 152(10): 2399-2404. doi:10.1016/j.pain.2011.07.005.
5. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011; 63 Suppl 11:S240-S252. doi:10.1002/acr.20543.
6. Hjermstad MJ, Fayers PM, Haugen DF, et al. Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011; 41(6): 1073-1093. doi:10.1016/j.jpainsymman.2010.08.016..
7. Lor M, Kim KS, Brown RL, Rabago D, Backonja M. Comparison of Four Pain Scales Among Hmong Patients with Limited English Proficiency. Pain Manag Nurs. 2021; 22(2): 205-213. doi:10.1016/j.pmn.2020.08.001.
8. Yazici Sayin Y, Akyolcu N. Comparison of pain scale preferences and pain intensity according to pain scales among Turkish Patients: a descriptive study. Pain Manag Nurs. 2014; 15(1): 156-164. doi:10.1016/j.pmn.2012.08.005.
9. 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: 1129-1139. Published 2021 Apr 21. doi:10.2147/JPR.S303305.
10. Taylor LJ, Herr K. Pain intensity assessment: a comparison of selected pain intensity scales for use in cognitively intact and cognitively impaired African American older adults. Pain Manag Nurs. 2003;4(2):87-95. doi:10.1016/s1524-9042(02)54210-7.
11. Li L, Liu X, Herr K. Postoperative pain intensity assessment: a comparison of four scales in Chinese adults. Pain Med. 2007; 8(3): 223-234. doi:10.1111/j.1526-4637.2007.00296.x.