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Low back pain: critical assessment of various scales

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


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.


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.


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.

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Fig. 1

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Abbey Pain Scale


Brief Pain Inventory


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After the French investigator who developed the tool


Faces Pain Scale


West Haven-Yale Multidimensional Pain Inventory


McGill Pain Questionnaire


Million’s Visual Analogue Scale


The North American Spine Society Lumbar Spine Outcome


Neuropathic Pain Scale


Oswestry Disability Index


Numerical Rating Scale


Pain Assessment in Advanced Dementia


Quebec Back Pain Disability Scale


Roland Morris Disability Questionnaire


Short Form-36


Visual Analogue Scale/Graphic Rating Scale


Verbal Rating Scale


Waddell Disability Index


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We thank Turacoz Healthcare Solutions (, Gurugram, India for writing support.

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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).

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