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Your Pain on a Scale of 1-10? Check Out a New DOD Way to Evaluate Pain

Image of Graphic of a bar graph. The DVPRS pain scale is being rolled out across the Military Health System and in civilian health care organizations as an improved way to determine pain levels.

If you receive care in a military hospital or clinic, you might notice your health care team is using a new method for assessing your pain.

The Military Health System uses a new pain management scale known as the Defense and Veterans Pain Rating Scale, or DVPRS.

Most people know the traditional way pain has been assessed during a medical appointment. Patients were usually asked to “rate your pain on a scale of 0-10.” While this was common practice for many years, growing evidence showed neither patients nor providers were satisfied with this approach.

The 0-10 reporting of a person’s pain often contributed to a goal of getting the pain to zero. Military pain management leaders shared that this often led to an overreliance on prescription pain medications which can have side effects that negatively impact on patients’ quality of life.

“Military medicine played a prominent role in changing the nature and focus of pain conversations between patients and clinicians,” said U.S. Navy Capt. (Dr.) Harold Gelfand, director of the Defense and Veterans Center for Integrative Pain Management, the Department of Defense’s center of excellence for pain management, aligned to the Uniformed Services University of the Health Sciences.

“Based on their collective clinical experiences and conversations with patients, military providers recognized the need to expand our pain assessments beyond the single measure of pain intensity,” Gelfand said.

In response to this challenge, a DOD pain management task force developed the DVPRS, which combines several previously validated and familiar pain assessment tools with some important additions.

Gelfand explained that the DVPRS incorporates functional descriptions for each of the 0-10 levels of pain so that successful pain management is also tied to improved function rather than simply getting pain to zero.

The DVPRS also includes an assessment of the patient-reported impact of pain on four specific quality of life indicators: activity, sleep, mood, and stress. This provides clinicians with a deeper understanding of the patient’s pain condition and a better way to measure the progress and effectiveness of pain management treatments.

The DVPRS was developed while the MHS focused on improving pain management outcomes. Many Iraq and Afghanistan veterans were facing chronic pain conditions, and health experts were looking for strategies to minimize the unnecessary use of prescription pain medications.

Beyond the MHS, the DVPRS has gained attention in numerous civilian health care organizations. For example, the West Virginia University Health System designated the DVPRS as its pain assessment tool in response to many of the same issues facing military medicine.

For more information, watch the DVPRS information video.

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Last Updated: July 11, 2023
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