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Rehabilitation Measure

Bryce-Ragnarsson Pain Taxonomy

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The BR-SCI-PT classifies pain in SCI patients in terms of pain localization in one of three higher-order regions (above, at, or below level of injury). Regional pain categories are then defined as either nociceptive or neuropathic. Finally, categories are subdivided into 1 of 15 specific subtypes.

Acronym BR-SCI-PT

Area of Assessment


Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil




Key Descriptions

  • The BR-SCI-PT is based on a 3-tiered decision schema:
    1) Pain in Tier 1 is localized relative to the level of SCI (i.e. either above, at or below level).
    2) Pain in Tier 2 is identified as either nociceptive or neuropathic.
    3) Pain in Tier 3 is stratified by subtypes of the area of localized nociceptive or neuropathic pain.
  • Pain in Tier 1 is localized relative to the level of SCI (i.e. either above, at or below level).
  • Pain in Tier 2 is identified as either nociceptive or neuropathic.
  • Pain in Tier 3 is stratified by subtypes of the area of localized nociceptive or neuropathic pain including:
    1) Mechanical/Musculoskeletal
    2) Autonomic dysreflexia headache
    3) Other
    4) Compressive neuropathy
    5) Other
    6) Mechanical/Musculoskeletal
    7) Visceral
    8) Radicular
    9) Compressive neuropathy
    10) Complex neuropathy
    11) Complex regional pain syndrome
    12) Mechanical/Musculoskeletal
    13) Visceral
    14) Central
    15) Other

Number of Items


Time to Administer

10-20 minutes

Required Training

Reading an Article/Manual

Age Ranges


13 - 17



18 - 64


Elderly Adult

65 +


Instrument Reviewers

Initially reviewed by the Rehabilitation Measures Team in 2011; Updated by Rachel Tappan, PT, NCS, Eileen Tseng, PT, DPT, NCS, and the SCI EDGE task force of the Neurology Section of the APTA in 2012.

ICF Domain

Body Function

Measurement Domain


Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:



Highly Recommend




Reasonable to use, but limited study in target group  / Unable to Recommend


Not Recommended

Recommendations for use based on acuity level of the patient:


Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post)

Subacute (CVA 2 to 6 months) (SCI 3 to 6 months)

Chronic (> 6 months) 





Recommendations based on SCI AIS Classification:







Recommendations for entry-level physical therapy education and use in research:


Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)





Not reported


Bryce-Ragnarsson Pain Taxonomy translations:

French (p98):
Spanish (p52):

These translations, and links to them, are subject to theTerms and Conditions of Use of the Rehab Measures Database. RIC is not responsible for and does not endorse the content, products or services of any third-party website, and does not make any representations regarding its quality, content or accuracy. If you would like to contribute a language translation to the RMD, please contact us

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Spinal Injuries

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Interrater/Intrarater Reliability

Spinal Cord Injury: (Bryce et al, 2006; n = 39; 135 vignettes describing people with SCI were presented to 5 groups of physicians)

  • 83% of physicians correctly rated pain into one of 15 BR-SCI-PT pain types
  • 93% of physicians correctly categorized pain in terms of level (at/Above/Below level of injury)
  • 90% of physicians correctly categorized pain as either nociceptive or neuropathic
  • Adequate interrater reliability (k = 0.70)

Content Validity

Literature Review: (Bryce et al, 2007; Expert occupations; Physicians, Psychologists, Physical therapists, Occupational therapist, Nurses & Others)

Voting on Pain Classification Validity / Usefulness

Instrument and number of experts voting

Valid and useful % (n)

Useful but requires more validation % (n)

Useful but requires changes/improvement then further validation % (n)

Not useful or valid for research in SCI % (n)

BR-SCI-PT(n = 59)

14 (8)

42 (25)

36 (21)

8 (5)

Cardenas (n = 56)

4 (2)

20 (11)

52 (29)

25 (14)

IASP (n = 59

19 (11)

47 (28)

31 (18)

3 (2)


Bryce, T. N., Budh, C. N., et al. (2007). "Pain after spinal cord injury: an evidence-based review for clinical practice and research. Report of the National Institute on Disability and Rehabilitation Research Spinal Cord Injury Measures meeting." Journal of Spinal Cord Medicine 30(5): 421-440. Find it on PubMed

Bryce, T. N., Dijkers, M. P., et al. (2006). "Reliability of the Bryce/Ragnarsson spinal cord injury pain taxonomy." J Spinal Cord Med 29(2): 118-132. Find it on PubMed

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