The Repeatability of Pain Site Diagrams

Abstract

Objectives: While pain diagrams have been in frequent use for the assessment of patients presenting with musculoskeletal symptoms, there has been little study of their repeatability. A diagram of pain site was accordingly investigated.

Methods: Four hundred and twenty-four patients attending a shoulder clinic with unilateral symptoms were asked to mark the areas in which pain was experienced, and 269 who had not received treatment in the intervening period were asked to complete a second diagram after a delay of approximately two weeks [median 15 days]. The diagrams were analyzed for the repeatability of the marking of each pain site and of the overall pain distributions.

Results: The initial diagrams showed wide variation with 124 different distributions seen. The kappa values for repeatability for individual pain sites were all less than 0.65, while the kappa value for repeatability of the pain distributions was 0.32. The number of marks in contiguous regions, assessing near agreement, differed significantly in almost all areas.

Conclusions: The analysis suggests that even a simple diagram of pain site showed only poor to moderate repeatability in this context, and that each diagram should be tested for repeatability before use in any particular patient group.

KEYWORDS:

• Pain
• body pain diagram
• regional pain