Pain 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 is necessary.

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 only.