The Visual Analogue Scale Versus Numerical Rating Scale in Measuring Pain Severity and Predicting Disability in Low Back Pain

Abstract

BackgroundLow back pain (LBP) is a public health problem that requires accurate assessment for proper management and predicting prognosis.ObjectiveThis study aims to assess the agreement between visual analogue scale (VAS) and numeric rating scale (NRS) in measuring LBP severity, and investigate their ability in predicting disability.MethodsA cross-sectional study was performed on 100 patients with chronic LBP. Pain severity assessment was performed using VAS, NRS, and pain severity scores of the Brief Pain Inventory (BPI). Disability assessment was done by BPI-Pain interference and Modified Oswestry Disability Index (MODI).ResultsThere was a significant positive correlation between VAS and NRS (r = 0.92, p < 0.001) with high agreement between both as detected by Bland-Altman method (mean difference = 0.33). Moreover, there was significant (p < 0.001) positive correlation between disability scores and either VAS (r = 0.92 with BPI pain interference; r = 0.75 with MODI) or NRS (r = 0.95 with BPI pain interference; r = 0.68 with MODI). By using receiver operating characteristic curve, a score of 6 in VAS or NRS can predict severe disability, whereas VAS score higher than 4 and NRS score higher than 3 can predict moderate disability.ConclusionsVisual analogue scale and NRS appeared reliable in assessing LBP severity with no significant difference between them. Moreover, either VAS or NRS scores can predict disability of patients with LBP.

Comparing Pain Intensity Using the Numeric Rating Scale and Defense and Veterans Pain Rating Scale in Patients Revisiting the Emergency Department

“…The NRS predicting ED administration of opioid medications in our patient sample demonstrates the power of pain scales to influence pain management, specifically opioid administration, in acute care settings like the ED. Others have also reported associations between unidimensional pain scales and increased analgesia administration and opioid adverse events [ 14 , 15 ]. Our results of increasing NRS pain category severity predicting ED opioid administration and DVPRS differentiating between moderate and high levels of pain coupled together suggest that patients may receive fewer opioid medications in the ED if the DVPRS (and not NRS) is used to measure pain intensity.…”

“…While it is important to address pain, failure to fully characterize a patient’s pain or sole reliance on NRS to guide treatment has been associated with increased incidence of opioid adverse drug reactions, including oversedation [ 13 ]. While the NRS has been compared against other pain instruments, such as the Visual Analog Scale (VAS) and the Verbal Rating Scale (VRS), to our knowledge the correlation of the NRS with the pain intensity component of the DVPRS has not yet been studied within the literature [ 7 , 14 ]. To determine the relationship between DVPRS and NRS as measures of pain intensity, we compared pain scores to sociodemographics, opioid treatment data, and if ED return visit was for pain in patients revisiting the ED within 30 days of an index visit.…”

Exhaled-Breath Testing Using an Electronic Nose during Spinal Cord Stimulation in Patients with Failed Back Surgery Syndrome: An Experimental Pilot Study

“…Patients completed this questionnaire twice; once when SCS was switched off for 12 h and once when SCS was reactivated for 30 min. The VAS pain score is a reliable and valid tool that is sensitive to change [28][29][30][31].…”

Electrochemical Skin Conductance Alterations during Spinal Cord Stimulation: An Experimental Study

“…Patients completed this questionnaire twice; once when SCS was switched off and once when SCS was activated. The VAS pain score is a reliable and valid tool that is sensitive to change [40][41][42][43].…”