Tunk’s Classification Scheme

The Tunks model identifies 11 types of pain for those with spinal cord injury according to the lesion level (Tunks 1986). 

Number of items: N/a

Procedure/Administration: Information is obtained through a semi-structured interview. This pain classification allows the clinician to describe the general location and whether the pain differentiates between several types of pain.

How scored: N/a

Interpretability: This system requires considerable knowledge from the clinician classifying the pain as well as from other health care professionals who may be using the information to help with pain management.

Acceptability: The tool should be augmented using a battery of other tools that would address pain duration, location and intensity in order to provide a complete picture of pain.  

Languages: N/a

Usability: Although this system has merit for giving more categories for which to describe the various types of pain an individual may have, it most likely would be useful for more complex pain cases where more time is allocated towards understanding the origins of the individual’s pain.

Time to administer: 15-20 minutes (longer for complex cases)

Time to score: N/a

Training required: No formal training is required but knowledge about neuroanatomy, physiology (specifically sensation) and theories of pain is an asset.

Availability: N/a

Equipment required: N/a

Summary: The classification system does not follow a systematic method for acquiring the data from the patients, thus obtaining consistent information from one time to another or between individuals very difficult. This system is very clinician dependent as it requires considerable knowledge about the various origins of pain to be able to interpret the patient’s comments into the defined classification scheme.

 Psychometric Summary:

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= AInter O: Red light single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

N/a= No information.

References

• Putzke JD, Richards JS, Ness T, Kezar L. Interrater reliability of the International Association for the Study of Pain and Tunks' spinal cord injury pain classification schemes. Am J Phys Med Rehabil 2003;82:437-440.
• Tunks E. Pain in spinal cord injured patients. In: Bloch R, Basbaum M (ed). Management of Spinal Cord Injuries. Williams and Wilkins, Baltimore, MD, 1986: p 180-211.