Low back pain: critical assessment of various scales

Abstract

Purpose

To study the various pain assessment tools based on their psychometric properties and ease of use.

Methods

Published articles on psychometric properties of pain tools were accessed and data collected for low back pain (LBP)-specific tools, generic tools, neuropathic LBP tools, tools for cognitively impaired patients, and tools for acute LBP.

Results

Among the LBP-specific tools, Roland Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) have good construct validity and reliability, and responsiveness over short intervals. Quebec Back Pain Disability Scale (QBPDS) gauges only disability and sleep. Among the generic tools, McGill Pain Questionnaire (MPQ), West Haven-Yale Multidimensional Pain Inventory (MPI), and Brief Pain Inventory (BPI) show good responsiveness, but BPI is the only tool validated for LBP. Neuropathic Pain Scale (NPS) and Short Form-MPQ-2 (SF-MPQ-2) are both reliable tools for neuropathic LBP. For cognitively impaired patients, Pain Assessment in Advanced Dementia (PAINAD), Abbey Pain Scale (APS), and Doloplus-2 are all reliable tools, but PAINAD has good construct validity. For acute pain, Clinically Aligned Pain Assessment (CAPA) is reliable and responsive, but presently, unidimensional tools and SF-MPQ-2 are the tools most preferred.

Conclusion

Based on psychometric properties and ease of use, the best tools for LBP seem to be RMDQ/ODI (among LBP-specific tools), BPI (among generic tools), SF-MPQ-2/NPS (for neuropathic LBP), PAINAD (for cognitively impaired patients), and unidimensional tools and SF-MPQ-2 (for acute pain). Overall, BPI seems to be a tool that can be relied upon the most.

Graphic abstract

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Fig. 1

Abbreviations

APS:

Abbey Pain Scale

BPI:

Brief Pain Inventory

CAPA:

Clinically Aligned Pain Assessment

Doloplus:

After the French investigator who developed the tool

FPS:

Faces Pain Scale

MPI:

West Haven-Yale Multidimensional Pain Inventory

MPQ:

McGill Pain Questionnaire

MVAS:

Million’s Visual Analogue Scale

NASS-LSO:

The North American Spine Society Lumbar Spine Outcome

NPS:

Neuropathic Pain Scale

ODI:

Oswestry Disability Index

NRS:

Numerical Rating Scale

PAINAD:

Pain Assessment in Advanced Dementia

QBPDS:

Quebec Back Pain Disability Scale

RMDQ:

Roland Morris Disability Questionnaire

SF-36:

Short Form-36

VAS/GRS:

Visual Analogue Scale/Graphic Rating Scale

VRS:

Verbal Rating Scale

WDI:

Waddell Disability Index

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Acknowledgements

We thank Turacoz Healthcare Solutions (www.turacoz.com), Gurugram, India for writing support.

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Correspondence to Hardik Pathak.

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Garg, A., Pathak, H., Churyukanov, M.V. et al. Low back pain: critical assessment of various scales. Eur Spine J 29, 503–518 (2020). https://doi.org/10.1007/s00586-019-06279-5

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Keywords

  • Low back pain tools
  • Psychometric properties
  • RMDQ
  • ODI
  • BPI