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Chiropractic Research Review

Reliability of Pain Drawings

Clinicians have utilized pain drawings for more than 50 years and for a variety of purposes, including documentation of symptom location, evaluation of changes in pain, and prediction of treatment outcomes.

Although previous research has dealt with methods for interpreting drawings and the evaluator reliability of such a process, little data exist on patients' consistency in completing the drawings.

This study determined the ability of 45 patients with chronic low back pain to fill out a pain drawing similarly at two separate visits separated by an average of 244 days. All patients had gained insufficient relief from conservative care and were under evaluation as possible surgical candidates, primarily for disc-related pain. Repeatability was assessed for several scoring methods typically used in clinical practice and previously detailed in the literature, including the penalty point system, overall visual inspection, body regions, and a grid method.

Results showed that patients were consistent in completing the drawings as assessed by the different scoring methods. Repeatability did not vary substantially, even with the relatively lengthy time duration between completion of the drawings. Additionally, repeatability of the doctor to score the pain drawings using the penalty point system and visual inspection methods was high.

The author notes that in this patient group, back pain was chronic at the time of the second drawing, and suggests future studies to determine if repeatability will remain high in acute patients, in whom there may be a tendency for greater fluctuation in pain.

Ohnmeiss DD. Repeatability of pain drawings in a low back pain population. Spine 2000:25(8), pp980-88.

Chiropractic Research Review

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