The Relationship between Visual Analogue Scale and R(III) Nociceptive Flexion Reflex

Background: Pain is often measured using psychophysical scaling techniques. However, all of these methods found their limits, since they were based on the subjective sensations reported by the subjects. It is, therefore, desirable to validate psychophysical pain measures by simultaneously measuring some physiological correlate of nociception. We studied an objective method for measuring pain in human volunteer using R(III) nociceptive flexion reflex. Methods: Four different intensity of electrical stimuli between perception and 1.4 times the R(III) nociceptive flexion threshold were delivered to the sole of the feet in 8 normal volunteers. We measured the flexion reflex activity in the skin over the ipsilateral tibialis anterior muscle and subjects rated each stimulus on a visual analog scale (VAS) Results: Both R(III) nociceptive flexion reflex activity and VAS ratings showed a linear relationship with stimulus intensity and with each other in all volunteers. Conclusions: R(III) nociceptive flexion reflex elicited through electrical stimulation may used as an objective pain measurement, previsionary based on our study paradigm.