What is the clinical relevance of the Numerical rating scale for pain?

2018 ◽  
Author(s):  
Felicia Cox
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Importance ◽  
Patient Global Impression ◽  
Numerical Rating ◽  
Group A ◽  
Clinically Significant ◽  
Global Impression Of Change

The landmark paper discussed in this chapter is ‘Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale’, published by Farrar et al. in 2001. The numerical rating scale is now the standard instrument used in chronic pain studies to measure pain intensity. Farrar et al. determined the changes in pain intensity that were clinically significant for studies of chronic pain while measuring the patient’s global impression of change. The paper used pooled data from ten recent studies of pregabalin in 2,724 subjects. The authors reported a consistent relationship between pain intensity and patient global impression of change, regardless of study, disease type, age, sex, study result, or treatment group. A reduction of approximately two points on the numerical rating scale, or of 30% in the global impression of change of pain intensity, represented a clinically important difference.

scholarly journals Assessing Pain Intensity in Children with Chronic Pain: Convergent and Discriminant Validity of The 0 To 10 Numerical Rating Scale in Clinical Practice

2014 ◽  
Vol 19 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Danielle Ruskin ◽  
Chitra Lalloo ◽  
Khushnuma Amaria ◽  
Jennifer N Stinson ◽  
Erika Kewley ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Clinical Practice ◽  
Pain Intensity ◽  
Discriminant Validity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Clinic ◽  
Small Range ◽  
Convergent And Discriminant Validity ◽  
Numerical Rating

BACKGROUND: In clinical practice, children are often asked to rate their pain intensity on a simple 0 to 10 numerical rating scale (NRS). Although the NRS is a well-established measure for adults, no study has yet evaluated its validity for children with chronic pain.OBJECTIVES: To examine the convergent and discriminant validity of the NRS as it is used within regular clinical practice to document pain intensity for children with chronic pain. Interchangeability between the NRS and an analogue pain measure was also assessed.METHODS: A cohort of 143 children (mean [± SD] age 14.1±2.4 years; 72% female) rated their pain intensity (current, usual, lowest and strongest levels) on a verbally administered 0 to 10 NRS during their first appointment at a specialized pain clinic. In a separate session that occurred either immediately before or after their appointment, children also rated their pain using the validated 0 to 10 coloured analogue scale (CAS).RESULTS: NRS ratings met a priori criteria for convergent validity (r>0.3 to 0.5), correlating with CAS ratings at all four pain levels (r=0.58 to 0.68; all P<0.001). NRS for usual pain intensity differed significantly from an affective pain rating, as hypothesized (Z=2.84; P=0.005), demonstrating discriminant validity. The absolute differences between NRS and CAS pain scores were small (range 0.98±1.4 to 1.75±1.9); however, the two scales were not interchangeable.CONCLUSIONS: The present study provides preliminary evidence that the NRS is a valid measure for assessing pain intensity in children with chronic pain.

Clinical Importance of Changes on a Numerical Pain Rating Scale

2018 ◽  
pp. 185-188
Keyword(s):  
Chronic Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Importance ◽  
Pain Rating ◽  
Double Blind ◽  
Numerical Pain Rating Scale ◽  
Important Improvement ◽  
Numerical Rating ◽  
Pain Rating Scale

rThis case focuses on the numerical pain rating scale by asking the question: What degree of change on a 0-to-10 pain intensity numerical rating scale (PI-NRS) used for the assessment of chronic pain is associated with clinically important improvement? Patient data were taken from 10 completed studies of pregabalin treatment for chronic pain in diabetic neuropathy, postherpetic neuralgia, low back pain, fibromyalgia, and osteoarthritis. All 10 of the double-blind, placebo-controlled, parallel, multicenter chronic pain studies used a common study design with identical pain measures. The study findings suggest that a PI-NRS score decrease of 1.74 and a percentage change of 27.9% correlate with a clinically important improvement in pain symptoms.

scholarly journals Clinically significant changes in pain along the Pain Intensity Numerical Rating Scale in patients with chronic low back pain

PLoS ONE ◽  
2020 ◽  
Vol 15 (3) ◽  
pp. e0229228 ◽  
Author(s):  
Hidenori Suzuki ◽  
Shuichi Aono ◽  
Shinsuke Inoue ◽  
Yasuaki Imajo ◽  
Norihiro Nishida ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Low Back ◽  
Numerical Rating ◽  
Clinically Significant

Vibration anesthesia during carboxytherapy for cellulite: a study protocol

2022 ◽  
Author(s):  
Adria Yared Sadala ◽  
Érika Patrícia Rampazo ◽  
Richard Eloin Liebano
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Trial Registry ◽  
Expected Outcome ◽  
Numerical Rating ◽  
Group A ◽  
Group B ◽  
And Control

Background: To date, there has been no investigation addressing the effects of vibration anesthesia during carboxytherapy. Aim: Investigate the analgesic effect of different vibratory devices during carboxytherapy for the treatment of cellulite. Materials & methods: A total of 78 women between 18 and 49 years of age with cellulite in the gluteal region will be randomly allocated to three groups: Group A (carboxytherapy and vibratory device A), Group B (carboxytherapy and vibratory device B) and control group. Pain intensity will be assessed using a numerical rating scale after each puncture. Expected outcome: Vibration anesthesia is expected to be effective at diminishing the pain intensity caused by carboxytherapy comparison with the control group, with no differences between the vibratory devices. Trial registry: Brazilian Registry of Clinical Trials- ReBEC (RBR-8jcqy7c)

scholarly journals Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yasushi Motoyama ◽  
Yoshitetsu Oshiro ◽  
Yumiko Takao ◽  
Hitoaki Sato ◽  
Norihiko Obata ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Functional Connectivity ◽  
Resting State ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Predictive Marker ◽  
Significant Negative Correlation ◽  
Improvement Rate ◽  
Numerical Rating ◽  
Brain Functional Connectivity

Abstract Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-sample t-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.

scholarly journals The Role of Testosterone Supplemental Therapy in Opioid-Induced Hypogonadism: A Retrospective Pilot Analysis

2016 ◽  
Vol 11 (4) ◽  
pp. 1208-1213 ◽  
Author(s):  
Omer A. Raheem ◽  
Sunil H. Patel ◽  
David Sisul ◽  
Tim J. Furnish ◽  
Tung-Chin Hsieh
Keyword(s):  
Chronic Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Opioid Therapy ◽  
Total Testosterone ◽  
Chronic Noncancer Pain ◽  
Numerical Rating ◽  
Noncancer Pain ◽  
Supplemental Therapy

Chronic opioid therapy for pain management is known to induce several endocrine changes. The authors examined the effect of testosterone supplemental therapy (TST) in patients with chronic, noncancer pain undergoing opioid therapy. It was hypothesized that treatment of opioid-induced hypogonadism (OIH) can reduce opioid requirements in patients suffering from chronic pain and approve their quality of life. Over 18 months period, patients with OIH were identified in a tertiary referral pain center, Numerical Rating Scale (NRS) pain scores and daily morphine equivalent dose (MED) were the primary outcomes measured. Data were collected and comparative analysis performed between men undergoing TST versus nontreatment group. Twenty-seven OIH patients (total testosterone <300 ng/dL) were identified during the study period. TST group consists of 11 patients, while non-TST group consists of 16 patients as control cohort. Mean patient age (55 and 54.4, p = .4) and basic metabolic index (28.5 and 31.9, p = .07) in TST and non-TST groups, respectively. Mean follow-up total testosterone (ng/dL) was significantly higher after TST compared with the non-TST group (497.5 vs. 242.4 ng/dL, p = .03). Median follow-up NRS was 0 and 2 in the TST and non-TST groups ( p = .02). Mean MED (mg) decreased by 21 mg in TST group and increased by 2.5 mg in non-TST group ( p < .05). This study reports that treatment of OIH with TST can reduce opioid requirements in men with chronic pain as quantified by MED. It also confirms previous reports on the potential effects of OIH and that TST is effective in correcting opioid-induced endocrine abnormalities.

scholarly journals Effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients

2017 ◽  
Vol 5 (2) ◽  
pp. 631
Author(s):  
Zahra Abbas Ali Madadi ◽  
Jalil Azimian ◽  
Farzaneh Falahatpishe ◽  
Mahmoud Alipour Heidari
Keyword(s):  
Pain Intensity ◽  
Arteriovenous Fistula ◽  
Rating Scale ◽  
Control Method ◽  
Numerical Rating Scale ◽  
Simple Random Sampling ◽  
Hemodialysis Patients ◽  
Numerical Rating ◽  
Rating Scale Data ◽  
Frequent Hemodialysis

Background: Pain and stress of hemodialysis are experienced by more than 50% of patients who are suffering from renal disease; hence decreasing a part of these adverse effects can be effective on individual’s long term coping with hemodialysis. The current study was done to determine the effect of warm footbath with vibration on arteriovenous fistula puncture-related pain in hemodialysis patients.Methods: This clinical trial was conducted on 31 hemodialysis patients in 2014. The patients were selected by simple random sampling method and placed in one group. First, the pain intensity of all patients was measured in the six frequent hemodialysis sessions without any intervention (control method). After two weeks, the intervention of warm footbath with vibration was done on all patients and the pain intensity was measured for six frequent hemodialysis sessions (intervention method). The patients were received 40±2 °C footbath with vibration by foot massage spa machine for ten minutes; then, fistula needles were placed and the pain intensity was assessed by using a numerical rating scale. Data were analyzed by ANOVA and T test.Results: The study group had contained 20 males (64.5%), 11 females (35.5%), with an average age of 44.16±14.85 and a range of 18 to 65 years old, which shows that the pain intensity of the warm footbath with vibration method was lower than the control method (P< 0.05).Conclusions: Warm footbath with vibration can be used as an effective palliative method to reduce pain of hemodialysis patients.

Meta-analysis of the efficacy and safety of Sativex (nabiximols), on spasticity in people with multiple sclerosis

2010 ◽  
Vol 16 (6) ◽  
pp. 707-714 ◽  
Author(s):  
Derick T Wade ◽  
Christine Collin ◽  
Colin Stott ◽  
Paul Duncombe
Keyword(s):  
Multiple Sclerosis ◽  
Odds Ratio ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Meta Analysis ◽  
Treated Group ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Numerical Rating ◽  
Global Impression Of Change

Objective: To determine the efficacy of Sativex (USAN: nabiximols) in the alleviation of spasticity in people with multiple sclerosis. Methods: The results from three randomized, placebo-controlled, double-blind parallel group studies were combined for analysis. Patients: 666 patients with multiple sclerosis and spasticity. Measures: A 0—100 mm Visual Analogue Scale (VAS, transformed to a 0—10 scale) or a 0—10 Numerical Rating Scale (0—10 NRS) was used to measure spasticity. Patients achieving a ≥30% improvement from baseline in their spasticity score were defined as ‘responders’. Global impression of change (GIC) at the end of treatment was also recorded. Results: The patient populations were similar. The adjusted mean change of the numerical rating scale from baseline in the treated group was —1.30 compared with —0.97 for placebo. Using a linear model, the treatment difference was —0.32 (95% CI —0.61, —0.04, p = 0.026). A statistically significant greater proportion of treated patients were responders (odds ratio (OR) = 1.62, 95% CI 1.15, 2.28; p = 0.0073) and treated patients also reported greater improvement: odds ratio 1.67 (95% CI 1.05, 2.65; p = 0.030). High numbers of subjects experienced at least one adverse event, but most were mild to moderate in severity and all drug-related serious adverse events resolved. Conclusion: The meta-analysis demonstrates that nabiximols is well tolerated and reduces spasticity.

scholarly journals Jaw Exercise Therapy and Psychoeducation to Reduce Oral Parafunctional Activities for the Management of Persistent Dentoalveolar Pain

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Izumi Makino ◽  
Young-Chang Arai ◽  
Shuichi Aono ◽  
Masayuki Inoue ◽  
Hiroki Sakurai ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Combination Therapy ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
End Of Treatment ◽  
Before And After ◽  
Numerical Rating ◽  
Therapy Treatment ◽  
Nonpharmacological Treatments

Objective. To retrospectively analyze the effects of our original combination therapy treatment on patients with nonodontogenic persistent dentoalveolar pain. Methods. Twenty-one patients suffering from persistent dentoalveolar pain (nineteen females and two males; mean age ± standard deviation: 55.7 ± 19.6 years) participated in this study. They were treated with a therapy combination of jaw exercise and psychoeducation to reduce oral parafunctional activities every month. The intensity of pain in these subjects was evaluated using a numerical rating scale (NRS) before and after treatment. Results. The NRSs at the baseline ranged from 5 to 10 (median, 8), from 0 to 10 (median, 2) at one month after treatment, from 0 to 10 (median, 1) at three months after treatment, and from 0 to 10 (median, 0) at the end of treatment. Pain intensity after treatment improved significantly. Conclusion. There was a significant reduction in pain after our combination of therapies as nonpharmacological treatments, and therefore this treatment could be useful in the management of NPDP patients.

Agreement Between Verbal and Electronic Versions of the Numerical Rating Scale (NRS-11) when Used to Assess Pain Intensity in Adolescents

2015 ◽  
Vol 31 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Elena Castarlenas ◽  
Elisabet Sánchez-Rodríguez ◽  
Rocío de la Vega ◽  
Roman Roset ◽  
Jordi Miró
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating
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