|
Pain Level |
Description |
Comments |
|
10 |
 |
Word that describes what "10" means to you.
(What is your
functional ability at this level of pain? Describe briefly.) |
|
Give examples of what causes a "10".
How often or what % of your day are you at this level?
What do you do to relieve this level of pain? |
|
8 |
 |
Word that describes what "8" means to you.
(What is your
functional ability at this level of pain? Describe briefly.) |
|
Give examples of what causes an "8".
How often or what % of your day are you at this level?
What do you do to relieve this level of pain? |
|
6 |
 |
Word that describes what "6" means to you.
(What is your
functional ability at this level of pain? Describe briefly.) |
|
Give examples of what causes a "6".
How often or what % of your day are you at this level?
What do you do to relieve this level of pain? |
|
4 |
 |
Word that describes what "4" means to you.
(What is your
functional ability at this level of pain? Describe briefly.) |
|
Give examples of what causes a "4".
How often or what % of your day are you at this level?
What do you do to relieve this level of pain? |
|
2 |
 |
Word that describes what "2" means to you.
(What is your
functional ability at this level of pain? Describe briefly.) |
|
Give examples of what causes a "2".
How often or what % of your day are you at this level?
What do you do to relieve this level of pain? |
|
0 |
 |
Pain Free
(What is your
functional level when your pain is a "0"? Describe briefly.)
|
|
Give examples of when your pain level is a "0".
How often or what % of your day are you pain free?
What do you do to maintain "0" pain? |