Numerical rating scale for self-report of pain intensity in children and adolescents: recent progress and further questions.

Until very recently there has been an anomaly in the assessment of the intensity of pediatric pain. The most commonly used self-report scale is the one that, up to now, has had the smallest amount of supportive research. This scale, the numerical rating scale (NRS), is administered by asking patients to say a number, usually from 0 to 10, to express the intensity of their pain. Compared with well-known published scales such as the Faces Pain Scale – Revised, Wong-Baker FACES Pain Rating Scale, Oucher, Coloured Analogue Scale, and Pieces of Hurt, the NRS has the great advantage of requiring only a verbal interaction between the clinician and child, without the necessity for paper or plastic materials which can raise concerns about purchase, storage, distribution, and infection control. The NRS is well established with adults (Dworkin et al., 2005). However, very few studies before 2009 have reported using the NRS with children and adolescents, or have provided data supporting the use of this scale. Stinson et al. (2006), in their landmark systematic review of self-report measures, wrote: