Colored pain drawings: preliminary observations in a neurosurgical practice

R Masferrer, Virginia Prendergast, Peter Hagell

Research output: Contribution to journalArticlepeer-review

19 Citations (SciVal)


Background: Black and white pain drawings were introduced as a proposed means to identify patients, presenting with low back pain, who demonstrated functional overlay upon neurological testing. The use of color may enhance the usefulness of such pain drawings, but has not been described for adult patients. Aims: To retrospectively explore the use of colored pain drawings in patients with neck, low back, or radicular pain. Methods: Patients with neck, low back, or radicular pain referred to a community-based neurosurgical practice for evaluation during 1 year (n = 359) depicted their pain on anatomical drawings using colored pencils representing different pain characteristics. Patients with abnormal (n = 55) and normal (n = 54) pain drawings were selected for this study. Use of medications, findings on physical examination, radiographic findings, activity levels, Waddell signs, and pending litigation were recorded and compared between patients with normal and abnormal pain drawings, as assessed according to the Ransford penalty point system. Results: Patients whose colored pain drawings were abnormal, demonstrated a greater use of medications, more non-focal clinical findings, Waddell signs, impaired activity levels, involvement in pending litigation, and significantly fewer pathological radiographic findings than patients with normal pain drawings. Conclusions: Our findings agree with previous observations using black and white pain drawings, indicating that colored pain drawings are no less useful than the black and white approach. Further research is necessary to examine the psychometric properties and clinical usefulness of colored pain drawings to predict outcomes and/or determine treatment. (C) 2002 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Science Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)213-217
JournalEuropean Journal of Pain
Issue number3
Publication statusPublished - 2003

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Caring Sciences (Closed 2012) (016514020)

Subject classification (UKÄ)

  • Nursing


  • Waddell signs
  • pain drawings
  • pain assessment
  • colors
  • low back pain


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