numerical Pain Rating Scale (NPRS)

I hurt my back about a week ago. I've been getting therapy for it. Is it too soon to expect improvement?

It wouldn't be surprising either way at this point: improvement or no improvement. Getting "better" can be gauged in different ways. Do you have less pain? Can you sleep through the night? Can you get in and out of a car easily and without pain?

Measures of pain, motion, and function may vary from day to day but overall are you seeing some change? Some health care professionals like to use the numerical pain rating scale (NPRS) to measure change.

The patient circles a number on a straight line from zero (no pain) to 10 (worst pain). This can be done before treatment begins and then everyday, every week, or every month after for comparison.

The amount of change expected may depend on what kind of injury you had. Most soft tissue injuries heal completely in four to six weeks. The first 10 days are usually the most painful with a slow improvement from there.

Patients with chronic pain lasting more than two or three months from the time of injury may not see a change in pain on the scale. They would do better to look for change in function by asking, "What can I do now that I couldn't do yesterday? Last week? Last month?"

John D. Childs, PT, PhD, et al. Responsiveness of the Numeric Rating Scale in Patients with Low Back Pain. In Spine. June 1, 2005. Vol. 30. No. 11. Pp. 1331-1334.

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