The Numeric Pain Rating Scale (NPRS)

What is the NPRS?

The Numeric Pain Rating Scale (NPRS) is an 11-point numeric scale that asks patients to rate their pain from 0 (no pain) to 10 (worst pain imaginable). The measure is a simple way to assess your patient’s perceived level of pain over the past 24 hour period.

How is the NPRS Scored?

The NPRS is scored on a scale from 0-10 points, with higher scores indicating greater pain intensity. The measure is set to be sent to the patient at a predetermined cadence over a 2 year period of

 time. The minimal clinically important difference (MCID) may vary by patient population, however the generally accepted MCID is 2 points.

The MCID is the smallest change that a patient would notice and appreciate, and can be used to determine whether they are responding to treatment. If the patient’s score on an outcome measure changes by more than the MCID, it is likely that they are benefiting from the established treatment plan.

However, MCID is merely the floor clinicians and patients should be aiming for, as many patients exceed MCID by a substantial margin. Patient-reported outcome specific goals should be aligned with optimizing each patient’s recovery, versus solely attaining the MCID.

To best interpret results of patient-reported outcome measures and understand if your patient is making significant improvements, beneficial metrics other than the MCID should be referenced, such as the substantial clinical benefit (SCB). This value indicates the amount of change required for a patient to feel they significantly improved from an intervention. It is best practice to research your patient population for each case to determine if specific MCID or SCB values exist in the literature.

What is the Clinical Utility of the NPRS?

The NPRS score has excellent acceptance in the literature for a variety of conditions and regions of injury. The measure takes less than 1 minute to complete, is easy to administer, and has been proven in the research to be a valid and reliable scale for measuring pain intensity.

Why are Patients Sent the NPRS and PROMIS Pain Interference?

The NPRS measures pain intensity, or a rating of how ‘intense’ pain may feel. On the other hand, PROMIS Pain Interference measures the functional consequences of pain, and how pain may ‘interfere’ with activities of daily living. While both are aspects of pain, each tool measures a different and unique pain domain, all of which are important to understanding a patient’s overall progression throughout their care.