Scales and Assessments for Measuring and Recording Pain

Being able to effectively describe and quantify pain to healthcare professionals can be very difficult, and keeping track of your symptoms over time is even harder, especially with "Fibro-fog". However, being able to do so can be very useful and it is often recommended that patients keep pain or symptom diaries, but knowing where to start, what to include and how to quantify pain and symptoms can be complicated.

There are a number of scales, questionnaires and other assessments that can be used to quantify and record your symptoms in some way, which can be useful when keeping a symptom or pain diary, or in describing symptoms to a healthcare professional.

The Numeric Pain Scale is one of the simplest measures, with the pain at a particular time being assessed as being from 0 to 10, where 0 is no pain and 10 is the worst pain imaginable. This is sometimes used with the Visual Analogue Scale.

The Visual Analogue Pain Scale is a simple assessment tool consisting of a 10 cm line with 0 on one end, representing no pain, and 10 on the other, representing the worst pain ever experienced.

The Wong-Baker Faces pain Scale is recommended for children. Six faces showing expressions from a smile to sobbing are associated with simple pain descriptions for children to choose which best describes them.

The McGill Pain Questionnaire can be used to evaluate a person experiencing significant pain and it includes a number of useful pain descriptions. It can be used to monitor the pain over time and to determine the effectiveness of any intervention and it takes note of anything that worsens pain. However, it is quite lengthy.

The Pain Disability Index is a tool designed to help patients measure the degree to which their daily lives are disrupted by pain. It involves six 0-10 scales concerning the level of disability experienced with regard to Family/Home Responsibilities, Recreation, Social Activity, Occupation, Sexual Behaviour and Life-Support Activity.

The Fibromyalgia Impact Questionnaire is designed to quantitate the overall impact of Fibro over many dimensions including function, pain levels, fatigue, sleep disturbance and psychological distress. It looks at the past week, so would be suitable for a one-off assessment or as a weekly or monthly symptom diary. The FIQ is scored from 0 to 100 with the latter number being the worst case: the average score for patients seen by specialist consultants is about 50. The FIQ is widely used to assess change in Fibro status in research and it has been translated into several languages.

The Self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) Pain Scale is a modified version of the LANSS Pain Scale, which consists of five symptom items and two examination items usually performed by a doctor. The purpose of these scales is to assess whether the pain that is experienced is predominantly neuropathic or not. Both the LANSS and S-LANSS are scored out of 24; a score of 12 or more is strongly suggestive of neuropathic pain. These scales may be skewed by Fibro pain, which is neither purely neuropathic (from damaged nerves) or nociceptive (from damaged tissues).

The British Pain Society Pain Scales use 0-10 scales to assess pain at the time of assessment and during the preceeding week, how distressing the pain is/was and how much it inteferes with daily activities as well as how well treatments are working. They could provide a simple assessment for an effective weekly pain diary.