Ukponaye D Eboigbe, Aliyu Lawan, Alison Rushton, David M Walton
There was substantial heterogeneity in the types of pain/symptom maps used in musculoskeletal research, their methods of depiction, and modes of implementation, including the approaches used to quantify pain characteristics derived from them. The variation was evident across multiple dimensions, including body representation, anatomical segments, drawing instructions, and format, highlighting limited standardization across included studies. Future research should focus on efforts towards greater standardization in musculoskeletal pain mapping.
BACKGROUND: Musculoskeletal pain is a subjective, multidimensional condition that represents a leading cause of disability worldwide and presents substantial challenges for consistent assessment. Pain/symptom maps are commonly used to visually represent pain characteristics. This review aims to explore the existing literature and summarize the types of pain/symptom maps, their depiction methods, implementation modes, and derived pain characteristics.
METHODS: A comprehensive search was conducted across six databases and grey literature from 2000. The last search was performed on August 15, 2025. The protocol was prospectively published in PLOS One (https://doi.org/10.1371/journal.pone.0319498). Studies involving patient-reported pain/symptom maps were included. Data were extracted on the types of pain/symptom maps used in musculoskeletal research, their depiction methods, implementation modes, and pain characteristics derived.
RESULTS: Of 8050 identified studies, 563 were included, with 43% implementing a study-specific type of pain/symptom map. Key design features included no-proportional scale (97%), full-body representation (86%), non-segmentation (65%), androgynous (79%), and 2D format (91%). Paper-based implementation was most common (74%). Methods included marking (42%), shading (35%), and checking (20%). The most assessed singular pain characteristic was pain location (72%).
CONCLUSION: There was substantial heterogeneity in the types of pain/symptom maps used in musculoskeletal research, their methods of depiction, and modes of implementation, including the approaches used to quantify pain characteristics derived from them. The variation was evident across multiple dimensions, including body representation, anatomical segments, drawing instructions, and format, highlighting limited standardization across included studies. Future research should focus on efforts towards greater standardization in musculoskeletal pain mapping.