Defining Mild, Moderate, and Severe Pain in Persons with Multiple Sclerosis

Objective. To identify empirically derived cutoffs for mild, moderate, and severe pain in persons with multiple sclerosis (MS). Design. Cross-sectional survey. Setting. Community-based survey. Participants. Convenience sample of 236 individuals with MS and pain. Intervention. Not applicable. Main Outcome Measures. Zero to 10 Numeric Rating Scale for pain severity (both average and worst pain) and Brief Pain Inventory for pain interference. Results. The optimal classification scheme for average pain was 02 = mild, 35 = moderate, and 610 = severe. Alternatively, the optimal classification scheme for worst pain was 04 = mild, 57 = moderate, and 810 = severe. Conclusions. The present study furthers our ability to use empirically based cutoffs to inform the use of clinical guidelines for pain treatment as well as our understanding of the factors that might impact the cutoffs that are most appropriate for specific pain populations. The results of the present study also add to the existing literature by drawing similarities to studies of other populations, but also by highlighting that clear, between-condition differences may exist that warrant using different cutoffs for patients with different medical conditions. Specifically, the present study highlights that cutoffs may be lower for persons with MS than other populations of persons with pain.