Comparison of a pain tolerability question with the numeric rating scale for assessment of self-reported chronic pain

Review written by Dr Sandy Hilton info

Key Points

  1. Pain tolerability inversely correlates to the pain numeric rating scale.
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The debate on the helpfulness of the pain numeric rating scale has been going on for a long time and is yet to be resolved. Patients have reported that the scale reduces and depersonalizes their pain, and some argue that the scale should be abandoned entirely (1). A conflicting tension has been the need for the anchor of a numeric rating scale for use in research.

The authors of this study addressed the challenges of a numeric scale from a patient perspective. The study explored a tolerability question to “align patients’ expectations with realistic treatment goals” (2).

Patients have reported that the pain numeric rating scale reduces and depersonalizes their pain.
It should not simply be the goal of a person to be a 0/10 on a pain scale.


Participants were recruited electronically out of 157 primary practices. All patients had a pain-related diagnosis. They were asked the pain tolerability question (PTQ) - “Is your pain tolerable?” (Yes, No, or Not in Pain) - and to rate their average

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