Pain Indexes
OARSI has collected the most important indexes used by physicians and researchers to evaluate the algofunctional status of patients with chronic musculoskeletal diseases. Some of them are also relevant to evaluate the impact of pain on the patient’s psyche and on socio-professional relationships . These indexes are also useful for the monitoring of therapy in clinical surveys. This template allows an easy access to the indexes and gives a short description of their objectives. The links provide more information, including methods of use and references.
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Name of Index |
Description |
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OARSI-OMERACT Initiative: New OA Pain Measure |
As part of the OARSI-OMERACT Initiative, an 11-item tool, the Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP), designed to assess pain in patients with hip or knee OA has been developed. Please contact the author, Gillian Hawker, MD, M.Sc if you intend to use the instrument. Please indicate the setting and for what purpose. Contact: g.hawker@utoronto.ca Users Guide (ver 6) |
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Dallas Pain Questionnaire |
The Dallas Pain Questionnaire (DPQ), which is a 16-item visual analog tool was developed by Lawlis, McCoy, and Selby (appendix) for the purpose of evaluating subject’s cognitions about the percentage that chronic pain affects four aspects of the patients’ lives: 1) daily activities including pain and intensity, personal care, lifting, walking, sitting, standing, and sleeping; 2) work and leisure activities including social life, travelling, and vocational; 3) anxiety-depression and 4) social interest that includes interpersonal relationship, social support, and punishing responses. |
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Neck Pain and Disability Scale –NPAD |
Composite index including 20 items which measure the intensity of pain; its interference with vocational, recreational, social, and functional aspects of living ; and the presence and extent of associated emotional factors.
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WOMAC ™ |
The WOMAC™ Index is a disease-specific, tri-dimensional self-administered questionnaire, for assessing health status and health outcomes in osteoarthritis of the knee and/or hip. |
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AUSCAN™ |
The AUSCAN© Index is a disease-specific, tri-dimensional self-administered questionnaire, for assessing health status and health outcomes in osteoarthritis of the hand. |
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Roland and Morris |
A composite questionnaire to assess self-rated disability due to back pain |
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Lequesne |
Composite index assessing pain and disability |
Radiological Indexes
Lumbar Ostoarthritis
Seven different radiological grading systems for lumbar disc degeneration have been described to date. Two grading systems developed for disc degeneration can be recommended on the basis of their good inter-observer reliability.
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Name of Index |
Description |
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Lane index and Wilke index – Radiological indexes for lumbar osteoarthritis |
Seven different radiological grading systems for lumbar disc degeneration have been described to date. Two grading systems developed for disc degeneration can be recommended on the basis of their good inter-observer reliability (1, 2). There is no high quality grading system recommended for lumbar facet joints evaluation. Radiographic grading of lumbar disc degeneration is done on lateral view for the Lane grading system (1). This grading system asseses joint space narrowing, anterior and posterior osteophyte formation, and subchondral sclerosis with a scale from 0 (none) to 4 (severe). For the Wilke grading system, radiographic evaluation is done on both lateral and postero-anterior view (2). This grading system asseses height loss, osteophyte formation, and diffuse sclerosis with a scale from 0 to 3. |
Hand OA
Three indexes are presented: Kellgren Lawrence, Verbruggen and Kallman.
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Name of Index |
Description |
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Kellgren Lawrence – Hand OA radiological index |
Radiographs for hand OA could be either plain or digitalized images. Anteroposterior views of both hands on the same film are used. |
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Verbruggen index – Hand OA radiological index |
Radiographs for hand OA could be either plain or digitalized images. Antero-posterior views of both hands on the same film are used. |
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Kallman – Hand OA radiological index |
Radiographs for hand OA could be either plain or digitalized images. Antero-posterior views of both hands on the same film are used. |
ICOAP Pain Questionnaire
Aim. To conduct a multi-language translation and cross-cultural adaptation of the ICOAP pain questionnaire for hip and knee osteoarthritis (OA).
Methods. The questionnaires were translated and cross-culturally adapted in parallel, using a common protocol, into the following languages: English, Czech, Dutch, French , German, Italian, Norwegian, Spanish (Castillan), North and Central American Spanish, Swedish. The process was conducted following five steps: 1- independent translation into the target language by two or three persons; 2- consensus meeting to obtain a single preliminary translated version; 3- backward translation by an independent bilingual native English speaker, blinded to the English original version; 4- final version produced by a multidisciplinary consensus committee; 5- pre-testing of the final version with 10-20 target-language-native hip and knee OA patients.
Results. The process could be followed and completed in all countries. Only slight differences were identified in the structure of the sentences between the original and the translated versions. A large majority of the patients felt that the questionnaire was easy to understand and complete. Only a few minor criticisms were expressed. Moreover, a majority of patients found the concepts of constant pain and pain that comes and goes to be of a great pertinence and were very happy with the distinction.
Conclusion. The ICOAP questionnaire is now available for multicenter international studies.