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Updated: Jan 12, 2026

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The Best-Worst Scale in Non-Oncologic Lower Limb Pain.

Mariana Isabel Da Silva Fernandes1, Helena Donato2, Luiz Miguel Santiago3

  • 1Faculty of Medicine. Universidade de Coimbra. Coimbra. Portugal.

Acta Medica Portuguesa
|November 8, 2025
PubMed
Summary

The Best-Worst Scale (BWS) offers a superior method for assessing non-oncologic lower limb pain, improving patient satisfaction and quality of life. This approach better captures patient preferences compared to traditional pain intensity measures.

Keywords:
Chronic PainLower ExtremityOsteoarthritisPatient-Centered CareQuality of LifeSurveys and Questionnaires

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Area of Science:

  • Pain Management
  • Patient-Reported Outcomes
  • Healthcare Research Methodology

Background:

  • Non-oncologic lower limb pain significantly impacts patient quality of life and presents management challenges due to its complexity.
  • Traditional pain assessments often focus narrowly on intensity, neglecting comprehensive patient experiences and preferences.
  • The Best-Worst Scale (BWS) is an emerging tool in healthcare for understanding patient preferences and priorities.

Purpose of the Study:

  • To review existing literature on non-oncologic lower limb pain management and its implications.
  • To identify key concepts, evidence types, and research gaps related to this pain condition.
  • To explore the utility of the Best-Worst Scale (BWS) methodology in enhancing patient quality of life.

Main Methods:

  • A narrative review was conducted in October-November 2024.
  • Searches were performed in PubMed and the Revista Portuguesa de Medicina Geral e Familiar.
  • Included studies focused on chronic non-oncologic lower limb pain and the application of BWS.

Main Results:

  • 16 out of 124 articles were included in the review.
  • BWS is recognized as a valuable tool for healthcare research, with identified applications, benefits, and limitations.
  • Studies highlighted patient concerns, particularly in osteoarthritis, and treatment preferences.
  • Integrating BWS can improve pain assessment perception, patient satisfaction, and align treatment with patient goals.

Conclusions:

  • The Best-Worst Scale (BWS) demonstrates superiority over traditional methods for assessing non-oncologic lower limb pain.
  • BWS can reveal discrepancies between clinician and patient treatment goals.
  • Further research is needed to refine BWS implementation, validate its effectiveness, and integrate it into holistic, patient-centered care to improve quality of life.