“It’s not pain it’s discomfort”: development and investigation of a discomfort measurement scale.

Nicholas Harland, Cormac Ryan

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Logically, anecdotally and empirically, there appears to be
a shared understanding of the difference between 'pain' and
'discomfort'. Although discomfort is commonly referred to in
medical literature, it has never been objectively measured or
its properties examined.
This study devised a visual analogue discomfort scale (VAS-D)
and obtained a sample of n=128 outpatient musculoskeletal
physiotherapy patients who complete it alongside a traditional
visual analogue pain scale (VAS-P) and the EQ5D-5L.
Demographic data was also collected. The purpose of the
investigation was to preliminarily validate the VAS-D as a
psychometric index.
Scale scores and correlations are examined in the entire sample
and in sub-samples split by gender and pain severity. Scale
correlations were primarily moderate indicating the VAS-D
measures a related but distinct construct to pain and there
was a statistically significant difference between discomfort
scores when compared to pain. This indicates the VAS-D
measures a related, but distinct construct to pain. 7.8%
of respondents endorsed the VAS-D but scored zero on the
VAS-P. The relationships between pain and discomfort scores
held face validity, adding empirical evidence to a theoretical
relationship between the constructs.
As a preliminary study, it appears the VAS-D is a valid scale
that is distinct from a VAS-P. Data supports a hypothesis that
VAS-P scores may be lower or even absent in the concurrent
presence of a VAS-D measure. Clinical implications and
direction for future investigation are briefly discussed.
Original languageEnglish
Pages (from-to)19-23
Number of pages5
JournalPain and Rehabilitation: The Journal of the Physiotherapy Pain Association
Publication statusPublished - 31 Jan 2019


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