scales in multiple languages
The Society has produced a series of pain scales
in multiple languages to assist an encourage improved assessment
both by the healthcare professional and the patient, for whom English
is not their first language. Difficulty in assessing pain is one
common barrier that can inhibit effective treatment, particularly
when the patient's first language is not English, so it is hoped
that these pain scales will go some way to combat this.
The pain scales are recommended to be used by
GP's and Accident and Emergency staff and may well also prove useful
in a wider range of situations in which the communication of pain
The pain scales we present on the website are
judged to be easiest to use and best understood of the simple scales
available for adults with no cognitive impairment. The scales assess
different, partly separable, aspects of pain, plus pain relief.
They are not intended to be combined in total or averaged. The best
source of information about them is in a chapter: Jensen MP, Karoly
P, Self-report scales and procedures for assessing pain in adults,
in Turk DC and Melzack R (eds.), Handbook of Pain Assessment, 2nd
edition, New York: Guilford Press, 2001, pp 15-34.
The translations were done professionally into
the languages most often used in the UK by adults.
Reliability and validity
Because pain often fluctuates over time, a high index of test-retest
reliability is not the goal - it might indicate insensitivity to
change rather than reliability across time. As single item scales,
there is no question of internal consistency, and as self-report,
there is no inter-rater reliability. What helps to achieve reliability
is that the scale and the response options are easy to understand,
and in this it is somewhat better than the visual analogue scale.
Because pain is a subjective experience there
is no "gold standard" criterion for validity. However,
in a broad sense these pain ratings do bear the expected relationships
to related variables, such as disability and mood, and are also
correlated with the amount of activation in certain areas of the
brain concerned with pain processing [Coghill RC, McHaffie JG, Yen
Y-F (2003) Neural correlates of interindividual differences in the
subjective experience of pain. Proceedings of the National Academy
of Sciences 100 8538-8542].
Printing and downloading
The following pain scales can be downloaded and
printed free of charge from this web page. Arabic and Urdu are read
from left to right, instructions and scales, so have additional
instructions. Both of these languages, and Gujurati, have numerals
unlike those used in English and the 12 other scales.
Please Note: All the pain scales consist of the
foreign language scale followed by the English language translation.
The English scale at the top of the list is provided for information