Pain: a review of three commonly used pain rating scales
Open accessAbstract
Aims and objectives. This review aims to explore the research available relating to three commonly used pain rating scales, the Visual Analogue Scale, the Verbal Rating Scale and the Numerical Rating Scale. The review provides information needed to understand the main properties of the scales. Background. Data generated from pain‐rating scales can be easily misunderstood. This review can help clinicians to understand the main features of these tools and thus use them effectively. Method. A MedLine review via PubMed was carried out with no restriction of age of papers retrieved. Papers were examined for methodological soundness before being included. The search terms initially included pain rating scales, pain measurement, Visual Analogue Scale, VAS, Verbal Rating Scale, VRS, Numerical/numeric Rating Scale, NRS. The reference lists of retrieved articles were used to generate more papers and search terms. Only English Language papers were examined. Conclusions. All three pain‐rating scales are valid, reliable and appropriate for use in clinical practice, although the Visual Analogue Scale has more practical difficulties than the Verbal Rating Scale or the Numerical Rating Scale. For general purposes the Numerical Rating Scale has good sensitivity and generates data that can be statistically analysed for audit purposes. Patients who seek a sensitive pain‐rating scale would probably choose this one. For simplicity patients prefer the Verbal Rating Scale, but it lacks sensitivity and the data it produces can be misunderstood. Relevance to clinical practice. In order to use pain‐rating scales well clinicians need to appreciate the potential for error within the tools, and the potential they have to provide the required information. Interpretation of the data from a pain‐rating scale is not as straightforward as it might first appear.
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Pain intensity was measured by the Visual Analog Scale, Numerical Rating Scale, and Defense and Veterans Pain Rating Scale, which have demonstrated strong validity and reliability in clinical and research settings.
“The pain intensity was measured by the Visual Analog Scale, Numerical Rating Scale, and Defense and Veterans Pain Rating Scale, which have demonstrated strong validity and reliability in clinical and research settings [36-39].”
From Virtual Reality–Based Training in Chronic Low Back Pain: Systematic Review and Meta-Analysis of Randomized Controlled Trials (2024) · cites this paper as [39]
The Conclusion (page not provided) says the three scales reviewed are reliable and valid, and the Introduction identifies them as the Visual Analogue Scale, Numerical Rating Scale, and Verbal Rating Scale. The paper does not address the Defense and Veterans Pain Rating Scale, so it cannot support the validity and reliability claim for that scale. It also does not establish which scales the citing authors used to measure pain. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe NRS is considered a valid, reliable, and appropriate pain rating scale for use in clinical practice, with good sensitivity.
“The NRS is considered a valid, reliable, and appropriate pain rating scale for use in clinical practice, with good sensitivity [57].”
The NRS scale for measuring pain has good reliability and validity and has been shown to be sensitive to change.
“The NRS scale for measuring pain has good reliability and validity and has been shown to be sensitive to change [54, 55].”
From Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain? (2016) · cites this paper as [55]
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“The NRS scale for measuring pain has good reliability and validity and has been shown to be sensitive to change [54, 55].”
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“Typically, the VAS requires respondents to rate the severity of the symptom on a 10 cm scale, from 0 = not present to 10 = worst imaginable intensity of the symptom [74].”
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“The NRS is considered a valid, reliable, and appropriate pain rating scale for use in clinical practice, with good sensitivity [57].”
Method
- Authors
- Williamson, A., & Hoggart, B.
- Affiliations
- Heartlands Hospital (GB)
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2005-06-30
- Volume
- 14
- Issue
- 7
- Pages
- 798-804
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W1493918286
- Cited by
- 3,083
- References
- 50
- Citations by year
- 2026: 175 · 2025: 249 · 2024: 258 · 2023: 255 · 2022: 230 · 2021: 231 · 2020: 218 · 2019: 196 · 2018: 180 · 2017: 147 · 2016: 164 · 2015: 145 · 2014: 130 · 2013: 112 · 2012: 91
- FWCI
- 5.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Pfizer
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- pain scales, pain assessment, visual analogue scale, verbal rating scale, numerical rating scale, scale validity, scale reliability, clinical practice
- MeSH terms
- Humans, Nursing Assessment, Pain, Pain Measurement, Sensitivity and Specificity, Reproducibility of Results, Pain Threshold
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